Ultrastructural correlation of spectral-domain optical coherence tomographic findings in vitreomacular traction syndrome.
OBJECTIVE
To examine the ultrastructural correlates of spectral-domain optical coherence tomography (SD-OCT) findings in patients with vitreomacular traction (VMT).


METHODS
Observational case series.


METHODS
Retrospective analysis of six eyes of consecutive patients who underwent vitrectomy surgery for VMT was performed in this single-center, noncomparative study. One patient had a concurrent macular hole. Preoperative assessment included SD-OCT examination with 3-dimensional image reconstruction. During surgery the vitreous cone was dissected from the vitreous body using scissors, then removed from the surface of the retina with a combination of sharp dissection and peeling, and subsequently submitted for histologic and transmission electron microscopic processing.


RESULTS
SD-OCT showed prominent vitreal-foveal adhesion in all six eyes. Each eye had an epiretinal membrane (ERM) under the detached perifoveal posterior vitreous detachment. In all eyes this ERM appeared to course up the cone of attached vitreous and along the back surface of the posterior vitreous face. Ultrastructural analysis showed fibrocellular proliferations in the vitreous specimens in all six cases, which included retinal pigment epithelium (RPE) cells (five eyes), fibrocytes (four eyes), and macrophages (three eyes).


CONCLUSIONS
The adhesion between the vitreous and fovea in vitreomacular traction syndrome is accompanied by fibrocellular proliferation along the exposed surfaces of the inner retina and the posterior surface of the vitreous. This fibrocellular proliferation may augment the adhesion between the vitreous and fovea, and may account for the prominent OCT signal seen along the posterior surface of the vitreous in these cases.
Chang
Louis K
LK
Vitreous-Retina-Macula Consultants of New York, and the LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY 10022, USA.
Fine
Howard F
HF
Spaide
Richard F
RF
Koizumi
Hideki
H
Grossniklaus
Hans E
HE
D000368:Aged; D000369:Aged, 80 and over; D019773:Epiretinal Membrane / Q000473:pathology* / Q000601:surgery; D005128:Eye Diseases / Q000473:pathology* / Q000601:surgery; D005260:Female; D005347:Fibroblasts / Q000648:ultrastructure; D006801:Humans; D021621:Imaging, Three-Dimensional; D008264:Macrophages / Q000648:ultrastructure; D008266:Macula Lutea / Q000648:ultrastructure*; D008297:Male; D046529:Microscopy, Electron, Transmission; D010857:Pigment Epithelium of Eye / Q000648:ultrastructure; D012189:Retrospective Studies; D013577:Syndrome; D000267:Tissue Adhesions / Q000473:pathology; D041623:Tomography, Optical Coherence; D014821:Vitrectomy; D014822:Vitreous Body / Q000648:ultrastructure*