Abstract
Abstract: :
Purpose: Although the internal limiting membrane (ILM) peeling is very popular in the management of surgery for macular hole and macular edema, there have been some reports about complications of ILM peeling such as recovery delay of ERG b-wave and persistent macular edema. We reported the Aquaporin (AQP) expression in the ILM peeled off during macular hole surgery and showed the possibility of functional damage to the retina by ILM peeling. In this study, we examined the AQP expression in the ILM peeled off during surgery in idiopathic macular hole and diabetic macular edema. Methods: We performed vitrectomy with ILM peeling for 5 cases of idiopathic macular hole and 3 cases of diabetic macular edema. ILM obtained during surgery was reacted with anti-AQP antibody and then with secondary antibody labeled with colloidal gold for visualization. After a usual electron microscopic processing, we counted the colloidal gold particles in 600 nm length of ILM in idiopathic macular hole and diabetic macular edema. Results: The number of colloidal gold particles was 7.2+/-2.8 (n = 10) in idiopathic macular hole and 19.6+/-4.0 (n = 10) in diabetic macular edema, and was statistically different (p<0.01). From these results, there are two possibilities: since ILM of diabetic macular edema probably adheres strongly to Müller cells, more foot processes of Müller cells were peeled off; more AQPs were expressed to absorb macular edema. Conclusions: In the ILM peeled off during surgery, colloidal gold particles showing AQPs were observed more in the diabetic macular edema than in the idiopathic macular hole. Further examination is necessary to investigate the complication of ILM peeling and to determine the indication of ILM peeling.
Keywords: immunohistochemistry • macular holes • diabetic retinopathy