Vitreoschisis in macular diseases

• Published in: British journal of ophthalmology Vol. 95; no. 3; pp. 376 - 380
• Main Authors: Gupta, Priya, Yee, Kenneth M P, Garcia, Patricia, Rosen, Richard B, Parikh, Jignesh, Hageman, Gregory S, Sadun, Alfredo A, Sebag, J
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.03.2011; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Animals; anomalous PVD; Biological and medical sciences; California; Cell growth; Cytokines; Diabetes; Diabetic retinopathy; Disease; Female; Growth factors; Humans; Hypotheses; imaging; Immunohistochemistry; macula; Macula Lutea - diagnostic imaging; Macula Lutea - pathology; Macular degeneration; macular holes; Macular pucker; Male; Medical imaging; Medical sciences; Middle Aged; Miscellaneous; OCT/SLO; Ophthalmology; Ophthalmoscopy - methods; Pathogenesis; pathology; Primates; Radiography; Retina; Retinal Perforations - diagnostic imaging; Retinal Perforations - etiology; Retinal Perforations - pathology; Retinopathies; Studies; Surgery; Tomography; Tomography, Optical Coherence; vitreoschisis; vitreous; Vitreous Body - pathology; Vitreous Detachment - diagnostic imaging; Vitreous Detachment - pathology; Womens health; Huntington Beach California; California; Eye disease; Maculopathy; Ophthalmology
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.2009.175109

ObjectivesVitreoschisis is a possible pathogenic mechanism in macular diseases. Thus, the vitreoretinal interface was evaluated in monkey eyes and patients with various macular diseases in search of vitreoschisis. It is hypothesised that vitreoschisis is present in macular holes (MH) and macular pucker (MP), but not in other maculopathies.MethodsHistopathology was studied in 14 monkey eyes and a vitrectomy specimen of a patient with macular pucker. Optical coherence tomography/scanning laser ophthalmoscopy (OCT/SLO) was performed in 239 eyes: 45 MH, 45 MP, 51 dry age-related macular degeneration (AMD), 53 non-proliferative diabetic retinopathy (NPDR) and 45 controls.ResultsImmunohistochemistry demonstrated lamellae in the posterior vitreous cortex of 12/14 (86%) monkey eyes. With OCT/SLO, vitreoschisis was detected in 24/45 (53%) MH and 19/45 (42%) MP eyes, but in only 7/53 (13%) NPDR, 3/51 (6%) AMD and 3/45 (7%) control eyes (p<0.001 for all comparisons). Rejoining of the inner and outer walls of the split posterior vitreous cortex was visible in 16/45 (36%) MH eyes and 15/45 (33%) MP eyes. Histopathology of the MP specimen confirmed a split with rejoining in the posterior vitreous cortex.ConclusionsVitreoschisis was detected in half of eyes with MH and MP, but much less frequently in controls, AMD and NPDR patients. These findings suggest that anomalous PVD with vitreoschisis may be pathogenic in MH and MP.