title: Cells at the vitreoretinal interface in small full-thickness macular holes.
abstract: OBJECTIVE
  To report on total number, distribution, and type of cells at the vitreomacular interface in small full-thickness macular holes.
  
  
  METHODS
  Internal limiting membrane specimens were removed from 20 consecutive patients with macular holes <250 μm at times when pharmacologic vitreolysis was not available. Specimens were flat mounted and investigated by phase contrast and interference microscopy and immunocytochemistry. Clinical data were documented including optical coherence tomography analysis using the caliper function. Thirteen antibodies were used for glial cells, hyalocytes, macrophages, retinal pigment epithelial cells, different types of collagen, alpha-smooth muscle actin, and proliferating cells.
  
  
  RESULTS
  There was a positive correlation between macular hole size and cell density at the internal limiting membrane (Spearman's Rho: r = 0.519, P = 0.019). Mostly, single glial cells were found on the internal limiting membrane. In five patients, cell clusters were present. There was a strong immunoreactivity for glial cell markers. Immunoreactivity of hyalocyte markers, alpha-smooth muscle actin, and Ki-67 was found in cell clusters but otherwise sparse.
  
  
  CONCLUSIONS
  Single cells of glial origin without signs of proliferation or contraction are present in eyes with small full-thickness macular holes. In some eyes, however, clusters of cells can be seen, capable of proliferation and exerting tangential traction. Our findings emphasize the need for better visualization of the vitreoretinal pathology by optical coherence tomography, especially to distinguish between single cells and cell clusters.
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Ricarda G
authors.initials: RG
authors.lastname: Schumann
authors.forename: Felix
authors.initials: F
authors.lastname: Hagenau
authors.forename: Christos
authors.initials: C
authors.lastname: Haritoglou
authors.forename: Armin
authors.initials: A
authors.lastname: Wolf
authors.forename: Markus M
authors.initials: MM
authors.lastname: Schaumberger
authors.forename: Anselm
authors.initials: A
authors.lastname: Kampik
authors.forename: Arnd
authors.initials: A
authors.lastname: Gandorfer
mesh_terms: D000368:Aged; D015703:Antigens, CD; D001485:Basement Membrane / Q000473:pathology*; D002452:Cell Count; D005260:Female; D005904:Glial Fibrillary Acidic Protein; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008858:Microscopy, Phase-Contrast; D008875:Middle Aged; D009457:Neuroglia / Q000473:pathology*; D012160:Retina / Q000473:pathology*; D012167:Retinal Perforations / Q000150:complications* / Q000601:surgery; D041623:Tomography, Optical Coherence; D014746:Vimentin; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology*
chemical_list: D015703:Antigens, CD; D005904:Glial Fibrillary Acidic Protein; D014746:Vimentin