Histopathologic features of idiopathic macular holes and cysts.
The pathogenesis of idiopathic macular holes and cysts is currently debated. The authors studied the histopathologic features of 41 specimens. Of 22 full-thickness holes, 16 (73%) had epiretinal membranes (ERMs), 15 (68%) had cystoid macular edema (CME), and 3 (17%) were sealed by fibroglial and retinal pigment epithelial hyperplasia. Photoreceptors were variably degenerated, for a mean of 480 microns (range, 200-750 microns) from the hole margins. Of 12 lamellar macular holes, 6 (50%) had an ERM exhibiting tangential traction on the internal limiting membrane. Cystoid macular edema was present in five (71%) of seven macular cysts, and an ERM was noted in only one (14%). The authors' results suggest that ERM tangential traction may play a role in the pathogenesis of lamellar macular holes. Macular holes often have associated ERMs and CME, which may be potentially reversible.
Eye Pathology Laboratory, Wilmer Ophthalmological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
D R
DR
Guyer
W R
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Green
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de Bustros
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Fine
D000368:Aged; D000369:Aged, 80 and over; D003560:Cysts / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008269:Macular Edema / Q000473:pathology; D008297:Male; D010786:Photoreceptor Cells / Q000473:pathology; D010857:Pigment Epithelium of Eye / Q000473:pathology; D012164:Retinal Diseases / Q000209:etiology / Q000473:pathology; D012167:Retinal Perforations / Q000209:etiology / Q000473:pathology*