[Advantages of confocal microscopy in the analysis of epiretinal membranes and internal limiting membranes after macular surgery].
OBJECTIVE
To study specimens obtained from epiretinal membrane (ERM) and macular hole surgery with confocal microscopy and to evaluate its advantages in understanding their pathophysiology.


METHODS
This retrospective study included 50 patients undergoing surgery for epiretinal membrane (40 patients) or idiopathic macular hole (10 patients). Infracyanine green was used in 45 cases. Immunohistological examination of the excised tissues was undertaken using confocal microscopy after labeling with antibodies to glial fibrillary acidic protein (GFAP) and vimentin.


RESULTS
Confocal microscopic analysis of epiretinal membranes identified three types of tissues: 13 ERMs, which appeared thick and rich in cells, 20 internal limiting membranes (ILMs), which appeared thin, wrinkled and poor in cells, and seven composite tissues, where ERM and ILM were removed at the same time. The analysis of ten specimens obtained from macular hole surgery revealed nine ILMs and one composite tissue that were quite similar to those removed in epiretinal membrane surgery. In all, 27 specimens (10 ERMs, 12 ILMs and five composite tissues) contained GFAP-positive glial cells.


CONCLUSIONS
The confocal microscope provided a fast, three-dimensional analysis of ERMs and ILMs. An immunohistological study identified cells that take part in the genesis of the membranes. Glial cells were found both in ERM and ILM specimens. Our findings suggest that Müller's cells may contribute to the pathogenesis of ERM and macular hole development.
Dubreuil
F
F
Service d'Opthalmologie III, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, et Inserm U 598, 75012 Paris, France.
Ullern
M
M
Lozato
P
P
Rodrigues-Grillon
S
S
Baudouin
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019773:Epiretinal Membrane / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D012167:Retinal Perforations / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies