Abstract
Purpose: :
To investigate the pathogenesis of diffuse diabetic macular edema (DDME).
Methods: :
Internal Limiting Membrane (ILM) were surgically peeled from 10 eyes of 9 patients with DDME (DM group) and 12 eyes with non-diabetic macular hole, epiretinal membrane, and central retinal vein occlusion (non-DM group). We investigated the specimens by light microscope and transmission electron microscope, and compared with 2 groups.
Results: :
In the light microscope observations, many cells were observed on the inner surface of the ILM in DM group, and we confirmed 5 different cell types (glial cell, fibroblast like cell, macrophage, neutrophilie, and lymphocyte). In the transmission electron microscope observations, The ILMs in DM group were composed of heterolytic election-dense. The average thickness of the peeled ILMs was 4.26µm in the DM group and 2.31µm in non-DM group. The thickness of the ILM in the DM group was significantly increased compared with that in the non-DM group (Mann-Whitney U test p<0.01). And we confirmed 4 different cell types (glial cell, fibroblast like cell, macrophage, and lymphocyte) on the surface of vitreous side.
Conclusions: :
In the eyes with diabetic macular edema, the ILM thickened and many inflammatory cells were observed on the vitreous surface. Peeling ILM may remove physical barrier and inflammatory cells, and may lead to fluid resorption.
Keywords: diabetic retinopathy • pathology: human • vitreoretinal surgery