Morphologic studies of the peripheral vitreoretinal interface in humans reveal structures implicated in the pathogenesis of retinal tears.

Abstract

The ultrastructural nature of the preequatorial vitreoretinal interface was studied to elucidate the predisposing role for peripheral retinal tear formation. Fourteen enucleated globes from seven decreased patients were examined. The patients ranged in age from 16-88 years, with an average age of 40 years. None of the patients had a history of ocular or systemic disease that could have affected the eyes. Globes were examined by stereomicroscopy and by light and electron microscopy using the celloidin embedding method. On examination we found several structures in addition to tufts and rosettes. In the vitreous cortex, fibrillar structures with no vitreoretinal attachment to the retina frequently were found. We propose that these structures be called "tubuli" because of their spiral appearance. Mushroom-like structures, which we propose be referred to as "spiculae," were found to arise from the intact internal limiting lamina of the retina and to insert into the vitreous cortex, constituting foci of vitreoretinal adhesion. Other structures, which we propose be called "verrucae," arose from the disrupted internal limiting lamina of the retina and inserted into disrupted areas of vitreous cortex. Tubuli appear to be remnants of the embryonic vasculature with no clinical or pathologic significance. Because of their pattern of inserting into the internal limiting lamina of the retina and the peripheral vitreous cortex, spiculae and verrucae may play an important role in the formation of retinal breaks.