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Constantin J. Pournaras, Marie-Luce Bochaton-Piallat, Nicole Gilodi, Miltiadis K. Tsilimbaris, Efstratios Mendrinos; Myofibroblasts Are The Main Contracting Cellular Elements At The Border Of Stage III And IV Macular Holes . Invest. Ophthalmol. Vis. Sci. 2011;52(14):4489.
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Myofibroblasts play a major role in the production of retractile phenomena causing contraction or shrinkage of the epiretinal membranes (ERM) in proliferative vitreoretinopathy, diabetic retinopathy or idiopathic macular epiretinal membranes. The presence of a-smooth muscle actin (a-SMA)-positive myofibroblasts and of ED-A fibronectin (FN), one of the main inducers of myofibroblastic differentiation was studied in internal limiting membranes (ILM) removed during macular hole surgery.
Samples of ILMs following macular hole surgery in 9 eyes were collected. Double immunofluorescence staining with antibodies recognizing a-SMA and ED-A FN followed by confocal microscopy analysis as well as electronic microscopy were performed.
a-SMA and ED-A FN were detected in ILM removed in stage III and IV macular holes. ED-A FN was expressed in close relation with a-SMA-positive myofibroblasts predominately located close to the border of the macular hole area. Distally to the hole area the ILM specimens were a-SMA and ED-A FN negative. No a-SMA staining was observed in ILM specimens of stage II macular hole specimens.
Scanning electron microscopy indicated that cellular migration was not apparent around the macular hole in the early stage of the development of this pathology.Cellular elements expressing contractile properties related to a-SMA, typical of myofibroblasts differentiation, appear to be present at late stage macular holes.
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