Abstract
Purpose :
To provide immunohistochemical characterization of subretinal bands removed during retinal surgery in eyes with proliferative vitreoretinopathy (PVR).
Methods :
This study included eyes with the clinical diagnosis of PVR that underwent pars plana vitrectomy surgery during which the subretinal bands associated with retinal detachment was obtained. The subretinal bands were removed “en bloc” through a retinotomy using subretinal intraocular forceps. The excised tissue was sent for histopathologic analysis. Immunohistochemistry (IHC) was performed to confirm the cellular nature and components of these subretinal membranes. The IHC stains included, glial fibrillary acidic protein (GFAP), pancytokeratin, CD3, CD20, CD68 and CD34.
Results :
Subretinal membranes from 7 eyes were included in the analysis. All cases had successful surgical outcomes with reattachment six months after surgery. The microscopic examination of the excised tissue demonstrated following constituents of subretinal membranes: retinal pigment epithelial (RPE) cells (7/7), avascular spindle cell plaques of RPE cells metaplasia that stained positively with pancytokeratin (7/7). Fragments of gliotic GFA- positive neural retina was adherent to the fibrous plaque (6 /7). Bruch’s membrane was identified in one specimen. CD 68 positive macrophages were seen in 5/7 specimens and 2/5 of these specimens showed silicon oil- laden macrophages. Rare CD3 positive cells were also noted in one specimen.
Conclusions :
Removal of subretinal membranes is essential for successful reattachment of the retina. Subretinal bands in PVR are mainly composed of reactive avascular plaques of retinal pigment epithelial fibrous metaplasia and macrophage infiltration. The overlying gliotic retina or Bruch’s membrane are likely to be adherent to such plaques and might be inadvertently excised during removal of such membranes.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.