Clinicopathologic Changes of Vitreomacular Interface in Idiopathic Epiretinal Membrane with disorganization of retinal inner layers

Abstract

Purpose: To compare the pathological characteristics of the vitreomacular interface (VMI) of idiopathic epiretinal membrane (IERM) with and without disorganization of retinal inner layers (DRIL) and to correlate with clinical data. Methods: In this clinicopathologic study, the samples of ERM and internal limiting membrane (ILM) were extracted from DRIL (+) (19 eyes) and DRIL (-) (22 eyes) IERM eyes. Ultrathin series sectioning for transmission electron microscopy (TEM) and observed and correlated with surgery status and prognosis. Results: All IERM eyes presented fibrocellular membranes accompanied with vitreous collagen, glial cells and myofibroblasts, regardless of association with DRIL. A robust signal indicative of collagen type VI was observed in eyes DRIL (-), whereas collagen I was discovered in DRIL eyes. Cell debris and microvascular basement membrane was seen on the retinal side of DRIL eyes as well as a larger cell count on the vitreous side. These have more intraoperative complications and less surgery benefit. Conclusion: Although ILM peeling seems important, the histopathologic findings underscore the potential for retinal injury in DRIL (+) IERM eyes. This suggests that further research is needed to investigate individual preoperative assessment and to modify surgical procedures.