Abstract
Clinical and pathological features of non-vascularised epiretinal membranes are reviewed with special attention to focal epimacular fractional lesions in the elderly. The role of immunohistochemistry in elucidating the nature of component cells of complex epiretinal membranes is emphasised. Clinicopathological correlation establishes the ‘fibroglial membrane’ as the causative lesion of age-related epimacular traction. The pathogenesis of this process is discussed, including relevant animal models, and chronic inflammation and ischaemia (rather than acute posterior vitreous detachment) are implicated. Vitrectomy and epimacular membrane peeling results in significant visual improvement in most patients.
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References
Foos RY : Nonvascular proliferative extraretinopathies. Am. J. Ophthalmol. 1978; 87: 723–5.
Foos RY : The spectrum of nonvascular proliferative extraretinopathies. Chapter 6 in Ocular Pathology Update. Ed. D H Nicholson. Messon Publ. Co., New York, 1980.
Laqua H, Machemer R : Clinico-pathological correlation in massive periretinal proliferation. Am. J. Ophthalmol. 1975; 80: 913–29.
The Retina Society Terminology Commitee: The classification of retinal detachment with proliferative vitreoretinopathy. Ophthalmology 1983; 90: 121–5.
Gass JDM : Macular dysfunction caused by vitreous abnormalities. Chapter 11 (pp 200-215) in Stereoscopic Atlas of Macular Diseases. C V Mosby Co., St. Louis, 1970.
Wise GN : Clinical features of idiopathic preretinal macular fibrosis. Am. J. Ophthalmol. 1975; 79: 349–57.
Jaffe NS : Macular retinopathy after separation of vitreoretinal adherence. Arch. Ophthalmol. 1967; 78: 585–91.
Maumenee AE : Further advances in the study of the macula. Arch. Ophthalmol. 1967; 78: 151–65.
Kampik A, Green WR, Michels RG : Ultrastructural features of progressive idiopathic epiretinal membrane removed by vitreous surgery. Am. J. Ophthalmol 1980; 90: 797–809.
Sidd RJ, Fine SL, Owens SL, Patz A : Idiopathic preretinal gliosis. Am. J. Ophthalmol. 1982; 94: 44–8.
Michels RG : Vitreous surgery for macular pucker. Am. J. Opthalmol. 1981; 92: 628–39.
McLeod D, Marshall J, Grierson I : Epimacular membrane peeling. Trans. Ophthalmol. Soc. UK. 1981; 101: 170–80.
Trese MT, Chandler DB, Machemer R : Macular pucker I: Prognostic criteria. Graefe Arch. fur Ophthalmol. 1983; 221: 12–15.
Allen AW, Gass JDM : Contraction of a perifoveal epiretinal membrane simulating a macular hole. Am. J. Ophthalmol. 1976; 82: 684–91.
Margherio RR, Cox MS, Trese MT, Murphy PL, Johnson J, Minor LA : Removal of epimacular membranes. Ophthalmology 1985; 92: 1075–82.
Robertson DM, Buettner H : Pigmented preretinal membranes. Am. J. Ophthalmol. 1977; 83: 824–9.
Baines PS, Hiscott PS, McLeod D : Posterior non-vascularised proliferative extraretinopathy and peripheral nodular retinal telangiectasis. Trans. Ophthalmol. Soc. UK. 1982; 102: 487–91.
Hansen RI, Friedman AH, Gartner S, Henkind P : The association of retinitis pigmentosa with preretinal macular gliosis. Br. J. Ophthalmol. 1977; 61: 597–600.
Rice TA, de Bustros S, Michels RG, Thompson JT, Debanne SM, Rowland DY : Prognostic factors in vitrectomy for epiretinal membranes of the macula. Ophthalmology 1986; 93: 602–10.
Tanenbaum HL, Schepens CL, Elzeneiny I, Freeman HM : Macular pucker following retinal detachment surgery. Arch. Ophthalmol. 1970; 83: 286–93.
Hagler WS, Aturaliya U : Macular puckers after retinal detachment surgery. Br. J. Ophthalmol. 1971; 55: 451–7.
Lobes LA, Burton TC : The incidence of macular pucker after retinal detachment surgery. Am. J. Ophthalmol 1978; 85: 72–7.
Hirokawa H, Jalkh AE, Takahashi M, Takahashi M, Trempe CL, Schepens CL : Role of vitreous in idiopathic preretinal macular fibrosis. Am. J. Ophthalmol. 1986; 101: 166–9.
Foos RY : Vitreoretinal juncture—simple epiretinal membranes. Graefes Arch. fur Ophthalmol. 1974; 189: 231–50.
Wolter JR : Glia of the human retina. Am. J. Ophthalmol. 1959; 48: 370–92.
Daicker B, Guggenheim R, Gywat L : Findings on retinal surface by scanning electron microscopy III. Epivascular glial clusters. Graefes Arch. fur Ophthalmol. 1977; 204: 31–7.
Hiscott PS, Grierson I, Trombetta CJ, Rahi AHS, Marshall J, McLeod D : Retinal and epiretinal glia—an immunohistochemical study. Br. J. Ophthalmol. 1984; 68: 698–707.
Foos RY : Vitreoretinal juncture over retinal vessels. Graefes Arch. fur Ophthalmol. 1977; 204: 223–34.
Bellhorn MB, Friedman AH, Wise G, Henkind P : Ultrastructure and clinicopathologic correlation of idiopathic preretinal macular fibrosis. Am. J. Ophthalmol. 1975; 79: 366–73.
Szamier RB : Ultrastructure of the preretinal membrane in retinitis pigmentosa. Invest. Ophthalmol. 1981; 21: 227–36.
Roth AM, Foos RY : Surface wrinkling retinopathy in eyes enucleated at autopsy. Trans. Am. Acad. Ophthalmol. Otolaryngol. 1971; 75: 1047–58.
Foos RY : Surface wrinkling retinopathy. Chapter 3 (pp 23-38) in Vitreous Surgery and Advances in Fundus Diagnosis and Treatment. Ed. Freeman, Hirose and Schepens. Appleton-Century-Crofts. New York, 1977.
Parsons JH : The Pathology of the Eye, Volume 2. Publ. Hodder and Stoughton, London 1905.
Smith TR : Pathological findings after retina surgery. In: Importance of the Vitreous Body in Retina Surgery with Special Emphasis on Reoperations. Ed. Schepens CL. Publ. C V Mosby Co., St. Louis, 1960 (pp 61-75).
Clarkson JG, Green WR, Massof D : A histo-pathological review of 168 cases of preretinal membrane. Am. J. Ophthalmol. 1977; 84: 1–17.
Green WR, Kenyon KR, Michels RG, Gilbert HD, de la Cruz Z : Ultrastructure of epiretinal membranes causing macular pucker after retinal re-attachment surgery. Trans. Ophthalmol. Soc. UK. 1979; 99: 63–77.
Rentsch FJ : The ultrastructure of preretinal macular fibrosis. Graeafes Arch. fur Ophthalmol. 1977; 203: 321–37.
Newsome DA, Rodrigues MM, Machemer R : Human massive periretinal proliferation: in vitro characteristics of cellular components. Arch. Ophthalmol. 1981; 99: 873–80.
Kampik A, Kenyon KR, Michels RG, Green WR, de la Cruz Z : Epiretinal and vitreous membranes: comparative study of 56 cases. Arch. Ophthalmol. 1981; 99: 1445–54.
Trese M, Chandler DB, Machemer R : Macular pucker II: Ultrastructure. Graefes Arch. fur Ophthalmol. 1983; 221: 16–26.
Hiscott PS, Grierson I, McLeod D : Natural history of fibrocellular epiretinal membranes: a quantitative, autoradiographic and immunohistochemical study. Br. J. Ophthalmol. 1985; 69: 810–23.
Rodrigues MM, Newsome DA, Machemer R : Further characterisation of epiretinal membranes in human massive periretinal proliferation. Current Eye Research 1981; 1: 311–5.
Hiscott PS, Grierson I, McLeod D : Retinal pigment epithelial cells in epiretinal membranes: an immunohistochemical study. Br. J. Ophthalmol. 1984; 68: 708–15.
Foos RY : Vitreoretinal juncture; epiretinal membranes and vitreous. Invest. Ophthalmol. Visual Sci. 1977; 16: 416–22.
Foos RY : Personal communication 1986.
Foos RY, Simons KB : Vitreous in lattice degeneration of retina. Ophthalmology 1984; 91: 452–7.
Foos RY, Wheeler NC : Vitreoretinal juncture: synchisis senilis and posterior vitreous detachment. Ophthalmology 1982; 89: 1502–12.
Hiscott PS, Grierson I, Hitchins CA, Rahi AHS, McLeod D : Epiretinal membranes in vitro. Trans. Ophthalmol. Soc. UK. 1983; 103: 89–102.
Jiang DY, Hiscott PS, Grierson I, McLeod D (1986): Growth and contractility of cells from epiretinal membranes in primary culture Br. J. Ophthalmol (In Press).
Jaffe NS : Complications of acute posterior vitreous detachment. Arch. Ophthalmol. 1968; 79: 568–71.
Wise GN : Relationship of idiopathic preretinal macular fibrosis to posterior vitreous detachment. Am. J. Ophthalmol. 1975; 79: 358–62.
Rentsch FJ : Preretinal proliferation of glial cells after mechanical injury of the rabbit retina. Graefes Arch. fur Ophthalmol. 1973; 188: 79–90.
Miller B, Miller H, Patterson R, Ryan SJ : Retinal wound healing: cellular activity at the vitreoretinal interface. Arch. Ophthalmol. 1986; 104: 281–5.
Hiscott PS : Epiretinal membranes: a pathological, clinical and experimental study. PhD Thesis, University of London, 1986.
Hitchins CA, Grierson I, Hiscott PS : The effects of injections of cultured fibroblasts into the rabbit vitreous. Graefes Arch. fur Ophthalmol. 1985; 223: 237–49.
Ohsawa E, Miki T : Scanning electron microscopic observation of glial cells following xenon arc photocoagulation. Graefes Arch. fur Ophthalmol 1982; 218: 64–9.
Algevere P, Kock E : Experimental epiretinal membranes induced by intravitreal carbon particles. Am. J. Ophthalmol 1983; 96: 345–53.
Miller B, Miller H, Ryan SJ : Experimental epiretinal proliferation induced by intravitreal red blood cells. Am. J. Ophthalmol. (In Press).
Gloor BP : Mitotic activity in the cortical vitreous cells (hyalocytes) after photocoagulation. Invest. Ophthalmol. 1969; 8: 633–46.
Campochiaro PA, Glaser BM : Pathogenesis of proliferative vitreoretinopathy. 5th Vail Vitreoretinal Seminar, March 1986.
Yeo JH, Sadeghi J, Campochiaro PA, Glaser BM : Intravitreous fibronectin and platelet-derived growth factor: new model for traction retinal detachment. Arch. Ophthalmol. 1986; 104: 417–21.
Avery RL, Glaser BM : Inhibition of retinal pigment epithelial cell attachment by a synthetic peptide derived from the cell-binding domain of fibronectin. Arch. OphthalmoL 1986; 104: 1220–2.
Machemer R : Die chirurgische Entfernung von epiretinalen Makulamembranen (Macular pucker). Klin. Monatsbl. Augenheilkd. 1978; 173: 36–42.
Stenkula S, Ivert L : Sodium hyaluoronate (Healon) as an intravitreal aid in retinal and vitreous surgery. J. Ocul. Ther. Surg. 1984; 109–14.
Brihaye-Van Geertruyden M, Tassignon MJ : Traitement du syndrome de Jaffe par le Q switched Nd:Yag laser. Presentation to XV Meeting of Club Jules Gonin, August 1986.
Michels RG : Vitrectomy for macular pucker. Ophthalmology 1984; 91: 1384–8.
Michels RG : Surgery of epiretinal membranes. Dev. Ophthalmol. 1981; 2: 175–84.
Michels RG : A clinical and histopathological study of epiretinal membranes affecting the macula and removed by vitreous surgery. Trans. Am. Ophthalmol. Soc. 1982; 80: 580–656.
Barry PJ, Hiscott PS, Grierson I, Marshall J, McLeod D : Reparative epiretinal fibrosis after diabetic vitrectomy. Trans. Ophthalmol. Soc. UK. 1985; 104: 285–96.
Novak MA, Rice TA, Michels RG, Auer C : The crystalline lens after vitrectomy for diabetic reti-nopathy. Ophthalmology 1986; 93: 602–10.
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McLeod, D., Hiscott, P. & Grierson, I. Age-related cellular proliferation at the vitreoretinal juncture. Eye 1, 263–281 (1987). https://doi.org/10.1038/eye.1987.46
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DOI: https://doi.org/10.1038/eye.1987.46
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