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Ann E Barker-Griffith, Mark P Breazzano, Hengsheng Fang, Susan S Lee, Michael R Robinson, Jerrold L Abraham, Anatomy and Pathology; Ultra-structural study of vitreo-macular attachments related to macular ridges in Shaken Baby Syndrome. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4447.
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If macular ridges seen in Shaken Baby Syndrome relate to the vitreo-macular attachment anatomy at the area centralis, then strong vitreous fibers should be visible in young human and monkey eyes by scanning electron microscopy (SEM).
Monkey and more than 15 human donor globes, formalin-fixed, from infants and young adults, were dehydrated by ethanol, critical-point dried by CO2, and imaged by SEM. Selected tissues were processed for histology.
Monkey and young human (<39 years) eyes demonstrate strong, thick, vitreous fibril attachments at the area centralis that radiate in a circumferentially oriented pattern. This feature is absent in older humans (>60 years). All eyes reveal clearly visible retinal ganglion cells at the macula and area centralis, with associative fibers that span the pre-retinal surface. Monkey histology demonstrates vitreous fibers attaching to internal limiting membrane (ILM) at the area centralis.
Vitreal-retinal ring attachments have previously been described at the ILM in the retina1 and shown by us to be present at the macula in young human eyes2. We again demonstrate the characteristically strong attachments at the area centralis that also shows a partial canopy of vitreous fibers over this ring complex in additional young human eyes, as well as monkey eyes. Our anatomical observation may correlate with macular ridges found clinically and histopathologically in Shaken Baby Syndrome, specifically where vitreous fibers insert at the area centralis. 1. Hogan, Michael J: The vitreous, its structure, and relation to the ciliary body and retina, Investigative Ophthalmology, 2(5): 418-445, 1963. 2. Robinson, Michael R; Streeten, BW. Vitreoretinal ring attachments at the macula in normal young eyes: a scanning electron microscopic study. Invest. Ophthalmol. Vis. Sci. 28 (Suppl): 119, 1987.
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