En face optical coherence tomography of foveal microstructure in full-thickness macular hole: a model to study perifoveal Müller cells.
OBJECTIVE
To characterize perifoveal intraretinal cavities observed around full-thickness macular holes (MH) using en face optical coherence tomography and to establish correlations with histology of human and primate maculae.


METHODS
Retrospective nonconsecutive observational case series.


METHODS
Macular en face scans of 8 patients with MH were analyzed to quantify the areas of hyporeflective spaces, and were compared with macular flat mounts and sections from 1 normal human donor eye and 2 normal primate eyes (Macaca fascicularis). Immunohistochemistry was used to study the distribution of glutamine synthetase, expressed by Müller cells, and zonula occludens-1, a tight-junction protein.


RESULTS
The mean area of hyporeflective spaces was lower in the inner nuclear layer (INL) than in the complex formed by the outer plexiform (OPL) and the Henle fiber layers (HFL): 5.0 × 10(-3) mm(2) vs 15.9 × 10(-3) mm(2), respectively (P < .0001, Kruskal-Wallis test). In the OPL and HFL, cavities were elongated with a stellate pattern, whereas in the INL they were rounded and formed vertical cylinders. Immunohistochemistry confirmed that Müller cells followed a radial distribution around the fovea in the frontal plane and a "Z-shaped" course in the axial plane, running obliquely in the OPL and HFL and vertically in the inner layers. In addition, zonula occludens-1 co-localized with Müller cells within the complex of OPL and HFL, indicating junctions in between Müller cells and cone axons.


CONCLUSIONS
The dual profile of cavities around MHs correlates with Müller cell morphology and is consistent with the hypothesis of intra- or extracellular fluid accumulation along these cells.
Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland.
Alexandre
A
Matet
Department of Ophthalmology, Catholic University of Rome, Rome, Italy; Centro Italiano Macula, Rome, Italy.
Maria Cristina
MC
Savastano
Centro Italiano Macula, Rome, Italy; Nuovo Regina Margherita Hospital, Rome, Italy.
Marco
M
Rispoli
Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland.
Ciara
C
Bergin
Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland.
Alexandre
A
Moulin
Inserm, U1138, Team 17, From Physiopathology of Ocular Diseases to Clinical Development, Université Paris Descartes Sorbonne Paris Cité, Centre de Recherche des Cordeliers, Paris, France.
Patricia
P
Crisanti
Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland; Inserm, U1138, Team 17, From Physiopathology of Ocular Diseases to Clinical Development, Université Paris Descartes Sorbonne Paris Cité, Centre de Recherche des Cordeliers, Paris, France. Electronic address: francine.behar@gmail.com.
Francine
F
Behar-Cohen
Centro Italiano Macula, Rome, Italy.
Bruno
B
Lumbroso
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D003560:Cysts / Q000175:diagnosis*; D004195:Disease Models, Animal; D063928:Ependymoglial Cells / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005584:Fovea Centralis / Q000473:pathology*; D005974:Glutamate-Ammonia Ligase / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D008252:Macaca fascicularis; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D012164:Retinal Diseases / Q000175:diagnosis*; D012167:Retinal Perforations / Q000175:diagnosis*; D012189:Retrospective Studies; D058471:Subretinal Fluid; D014019:Tissue Donors; D041623:Tomography, Optical Coherence; D062826:Zonula Occludens-1 Protein / Q000378:metabolism
D062826:Zonula Occludens-1 Protein; D005974:Glutamate-Ammonia Ligase