Pathology of Internal Limiting Membrane Specimens Following Intravitreal Injection of聽Ocriplasmin

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• 作者：Ricarda G. Schumann ; ^{ricarda.schumann@med.uni-muenchen.de" class="auth_mail" title="E-mail the corresponding author} ; Armin Wolf ; Wolfgang J. Mayer ; Denise Compera ; Felix Hagenau ; Jean Ziada ; Anselm Kampik ; Christos Haritoglou
• 刊名：American Journal of Ophthalmology
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：160
• 期：4
• 页码：767-778
• 全文大小：3096 K

文摘

To describe ultrastructure and immunocytochemistry of internal limiting membrane peelings after unsuccessful treatment with ocriplasmin, to compare with untreated eyes, and to correlate with clinical imaging data.

Design

Interventional comparative case series.

Methods

Internal limiting membrane specimens were removed from 10 eyes with small macular holes and vitreomacular traction during vitrectomy after intravitreal ocriplasmin injection without release of traction or closure of macular holes during follow-up. Based on optical coherence tomography analysis, specimens from 10 other eyes without ocriplasmin treatment served as controls. All specimens were processed as flat mounts for phase-contrast microscopy followed by immunolabeling for fluorescence microscopy and embedding in epoxy resin with serial sectioning for transmission electron microscopy.

Results

Despite the absence of contractive epiretinal membranes on optical coherence tomography, we found epiretinal cells and vitreous collagen fibrils on the internal limiting membrane in specimens removed from eyes with and without previous pharmacologic vitreolysis. Immunolabeling revealed glial cells and hyalocytes in macular holes, whereas myofibroblasts were predominant in vitreomacular traction. There was no apparent damage of the vitreoretinal interface after unsuccessful pharmacologic vitreolysis compared to untreated controls.

Conclusions

Epiretinal cell proliferation and vitreous collagen fibrils with close adhesions to the internal limiting membrane are not always detectable by optical coherence tomography or may not have been recognized. Since they are associated with unsuccessful ocriplasmin treatment, presence and topography of epiretinal cells and vitreous collagen remnants on the internal limiting membrane should be further elucidated in order to refine criteria and indications for case selection in pharmacologic vitreolysis.