Abstract
PurposeTo describe characteristics of the vitreomacular interface (VMI) in traumatic macular holes (TMH) compared to idiopathic macular holes (IMH) using immunofluorescence and electron microscopy, and to correlate with clinical data.MethodsFor immunocytochemical and ultrastructural analyses, premacular tissue with internal limiting membrane (ILM) and epiretinal membrane (ERM) was harvested during vitrectomy from 5 eyes with TMH and 5 eyes with IMH. All specimens were processed as flat mounts for phase-contrast microscopy, interference and fluorescence microscopy, and transmission electron microscopy (TEM). Primary antibodies were used against microglial and macroglial cells. Clinical data was retrospectively evaluated.ResultsSurgically excised premacular tissue of eyes with TMH showed a less pronounced positive immunoreactivity for anti-glutamine synthetase, anti-vimentin and anti-IBA1 compared to eyes with IMH. Cell nuclei staining of the flat-mounted specimens as well as TEM presented a lower cell count in eyes with TMH compared to IMH. All detected cells were found on the vitreal side of the ILM. No collagen fibrils were seen in specimens of TMH. According to patients’ age, intraoperative data as well as spectral-domain optical coherence tomography (SD-OCT) analysis revealed an attached posterior vitreous in the majority of TMH cases (60%), whereas all eyes with IMH presented posterior vitreous detachment.ConclusionThe vitreomacular interface in TMH and IMH shows significant differences. In TMH, glial cells are a rare finding on the vitreal side of the ILM.
Highlights
The traumatic macular hole (TMH) is a rare full-thickness retinal tissue defect of the fovea with an interruption of all neural retinal layers leading to severe vision loss and1 3 Vol.:(0123456789)Graefe's Archive for Clinical and Experimental Ophthalmology includes 5–8.2% of all various types of macular holes [1,2,3]
Compared to a higher cell count and multi-layered cell composition in eyes with idiopathic macular holes (IMH), the fibrocellular composition shown in eyes with traumatic macular holes (TMH) revealed few single cells without tractive properties
Both entities presented a positive immunoreactivity for the macroglial cell markers antiVIM and anti-GS as well as for the microglial cell marker anti-IBA 1
Summary
The traumatic macular hole (TMH) is a rare full-thickness retinal tissue defect of the fovea with an interruption of all neural retinal layers leading to severe vision loss and1 3 Vol.:(0123456789)Graefe's Archive for Clinical and Experimental Ophthalmology includes 5–8.2% of all various types of macular holes [1,2,3]. The traumatic macular hole (TMH) is a rare full-thickness retinal tissue defect of the fovea with an interruption of all neural retinal layers leading to severe vision loss and. Unlike in idiopathic macular holes (IMH), spontaneous closure is common in TMH. The spontaneous closure rates vary between 10 and 50% [7, 12,13,14,15,16,17,18,19,20]. Functional prognosis is often limited due to accompanying trauma-induced retinal pathologies, respectively. Possible associated retinal pathologies are retinal or vitreous haemorrhage, choroidal rupture, damage of the retinal pigment epithelium (RPE), commotio retinae, subretinal choroidal neovascularisation and fibrosis [5]
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