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Mari Ueki, Takuji Kurimoto, Takaki Sato, Eisuke Ishizaki, Tsunehiko Ikeda, Yuro Shibayama; Comparison Of Histopathological Findings Between Idiopathic And Secondary Epiretinal Membranes. Invest. Ophthalmol. Vis. Sci. 2012;53(14):945.
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© ARVO (1962-2015); The Authors (2016-present)
Recent studies have shown that Müller glial cells express nestin and some cell-proliferation factors in monkey and human retinas, thus indicating the existence of retinal stem cells (Sugiyama et al., 2006, Bhatia et al., 2009). The expression of nestin is also known to be up-regulated under ischemic and traumatic pathological conditions of the retina (Xue et al., 2011, Goldenberg et al., 2011). The purpose of this present study was to examine the possibility that retinal stem cells contribute to the pathological condition of epiretinal membranes (ERMs). To test this possibility, immunohistochemistry with nestin, Ki-67, CD34, and glial fibrillary acidic protein (GFAP) antibodies was performed using idiopathic and secondary ERM specimens.
This study involved 10 cases of idiopathic ERMs and 3 cases of secondary ERMs including 2 eyes that underwent vitrectomy for retinal detachment (RD)and 1 eye that underwent vitrectomy for proliferative diabetic retinopathy (PDR). ERM specimens were obtained during pars plana vitrectomy and immediately fixed in 10% formalin. Paraffin sections were stained with hematoxylin eosin (HE) and immunohistochemical analysis was performed with nestin, Ki-67, CD34, and GFAP antibodies.
HE staining showed that some of the idiopathic ERM specimens consisted of internal limiting membrane. In contrast, numerous invasive cells were observed in the specimens of secondary ERMs compared to those of idiopathic ERMs. The PDR specimen consisted of endothelial cells forming a microvascular cavity. Immunohistochemical analysis revealed GFAP- positive cells in 4 of the 10 idiopathic ERMs cases and no nestin, Ki-67, or CD34 positive cells in those 10cases. In contrast, CD34-positive cells were observed in all 3 secondary ERMs cases, yet nestin, Ki-67, and GFAP positive cells were observed only in the 1 case that underwent vitrectomy for RD. Immunoreactivity in the nestin positive cells was well matched with that of the Ki-67 positive cells.
The findings of this study indicate that there are different histological characteristics between idiopathic and secondary ERMs. Immature cells of either CD34 or nestin positive cells in the retina might be related to secondary ERM formation.
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