title: Lamellar Hole-Associated Epiretinal Proliferation in Comparison to Epiretinal Membranes of Macular Pseudoholes.
abstract: OBJECTIVE
  To compare immunocytochemical and ultrastructural characteristics of "lamellar hole-associated epiretinal proliferation" in lamellar macular holes with "conventional epiretinal membrane" in macular pseudoholes.
  
  
  METHODS
  A consecutive observational case series, laboratory investigation.
  
  
  METHODS
  We analyzed surgically excised flat-mounted internal limiting membrane specimens and epiretinal membrane specimens removed from 25 eyes of 25 patients with lamellar macular holes (11 eyes) and macular pseudoholes (14 eyes) using interference and phase-contrast microscopy, immunocytochemistry, and transmission electron microscopy. By spectral-domain optical coherence tomography, epiretinal material of homogenous reflectivity without contractive properties was categorized as lamellar hole-associated epiretinal proliferation, whereas tractional epiretinal membranes presenting contractive properties were termed conventional epiretinal membrane.
  
  
  RESULTS
  Lamellar hole-associated epiretinal proliferation was seen in 73% of eyes with lamellar macular hole. Eyes with macular pseudohole presented with conventional epiretinal membrane. In lamellar hole-associated epiretinal proliferation, positive immunoreactivity for anti-glial fibrillary acidic protein, hyalocyte markers, and anti-collagen type I and III was seen. In contrast, specimens of macular pseudoholes were positive for α-smooth muscle actin and anti-glial fibrillary acidic protein, predominantly. Cellular ultrastructure showed that lamellar hole-associated epiretinal proliferation of lamellar macular holes mainly consisted of fibroblasts and hyalocytes, whereas myofibroblasts dominated in conventional epiretinal membranes of macular pseudoholes.
  
  
  CONCLUSIONS
  Cells within lamellar hole-associated epiretinal proliferation appear to originate from vitreous and possess less contractive properties than cells of conventional epiretinal membranes. Our findings point to differences in pathogenesis in a subgroup of lamellar macular holes presenting lamellar hole-associated epiretinal proliferation on the retinal surface.
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany. Electronic address: denise.compera@med.uni-muenchen.de.
authors.forename: Denise
authors.initials: D
authors.lastname: Compera
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Enrico
authors.initials: E
authors.lastname: Entchev
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Christos
authors.initials: C
authors.lastname: Haritoglou
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Renate
authors.initials: R
authors.lastname: Scheler
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Wolfgang J
authors.initials: WJ
authors.lastname: Mayer
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Wolf
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Anselm
authors.initials: A
authors.lastname: Kampik
authors.affiliation: Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Ricarda G
authors.initials: RG
authors.lastname: Schumann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D049109:Cell Proliferation; D019773:Epiretinal Membrane / Q000473:pathology* / Q000601:surgery; D005260:Female; D005347:Fibroblasts / Q000648:ultrastructure; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D046529:Microscopy, Electron, Transmission; D008858:Microscopy, Phase-Contrast; D008875:Middle Aged; D012165:Retinal Ganglion Cells / Q000648:ultrastructure; D012167:Retinal Perforations / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*