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F. Dubreuil, P. Lozato, M. Ullern, C. Baudouin; Confocal Microscopic Analysis of Epiretinal Membranes and Internal Limiting Membranes after Macular Surgey . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3045.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To study specimens obtained from macular surgery with confocal microscopy and compare the aspect of internal limiting membrane (ILM) of macular hole and of epiretinal membrane (ERM). Methods: This retrospective study included 32 patients undergoing surgery for epiretinal membrane (23 patients) or idiopathic macular hole (9 patients). Internal limiting membrane was removed in one or two times with the help of infracyanine green (ICG). Immunohistologic examination of the excised tissues was performed using confocal microscopy after labelling with antibodies to glial fibrillary acidic protein (GFAP) and vimentin. Results: Confocal microscopic analysis of epiretinal membranes enabled to identify three kinds of tissues: 17 ERMs that appeared thick, rich in cells, 17 ILMs, which were peeled secondly after staining with ICG, and 6 composite tissues, where ERM and ILM were removed at the same time. The 9 ILMs obtained from macular hole were quite similar to those removed in epiretinal membrane surgery. Both types appeared thin, wrinkled, and poor in cells. Nine ERMs and four ILMs contained GFAP-positive glial cells and a contingent of vimentin-positive cells. Conclusions: The confocal microscope offered a fast, three-dimensional analysis of ERMs and ILMs. Confocal microscopy did not reveal any obvious morphological difference between ILMs of ERM and ILMs of macular hole. Glial cells were only inconstantly found both in ERM and ILM specimens. Our findings suggest that glial cells may contribute to the pathogenesis of ERM and macular hole development.
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