Sach J, Karel I, Kalvodová B, Dotrelová D
Ustav patologie 3. LF UK, Praha.
Cesk Slov Oftalmol. 2000 Sep;56(5):286-92.
To analyze the ultrastructural features of epimacular tissue removed during idiopathic macular hole (IMH) surgery and to compare them with those of idiopathic epimacular membranes.
Three consecutive patients with unilateral stage 3 IMH underwent pars plana vitrectomy with surgical removal of delicate gelatinous membranous epimacular tissue. One patient was previously treated with laser photocoagulation. The excised material was investigated by means of light and transmission electron microscopy. Results were compared with the findings of the excised material in two idiopathic epimacular membranes.
The excised material included variable proportions of cellular and membranous material. Glial cells (Müller cells, fibrous astrocytes) and fibroblast-like cells dominated in the cellular component both in the specimens from IHM eyes and in the comparative material. Neural elements were revealed in two of three specimens from IMH eyes. Membraneous material was formed by fragments of internal limiting membrane.
Dominance of the glial cells in the cellular component of epimacular formations may reflect the important role of these cells both in formation and in healing process of IMH. The presence of neural elements in the removed epimacular tissue suggests that, at least in some cases, IMH surgery with peeling of an epimacular membrane can be associated with some injury of the macula.
分析特发性黄斑裂孔（IMH）手术中切除的黄斑前组织的超微结构特征，并将其与特发性黄斑前膜的超微结构特征进行比较。
连续3例单侧3期IMH患者接受了玻璃体切除术，术中切除了精细的凝胶状黄斑前膜组织。1例患者曾接受过激光光凝治疗。对切除的组织进行光镜和透射电镜检查。将结果与2例特发性黄斑前膜切除组织的检查结果进行比较。
切除的组织包括不同比例的细胞成分和膜性成分。在IMH眼标本和对照材料中，神经胶质细胞（ Müller细胞、纤维性星形胶质细胞）和成纤维细胞样细胞在细胞成分中占主导地位。在3例IMH眼标本中的2例中发现了神经成分。膜性成分由内界膜碎片形成。
黄斑前膜形成的细胞成分中神经胶质细胞占主导地位，这可能反映了这些细胞在IMH形成和愈合过程中的重要作用。切除的黄斑前组织中存在神经成分提示，至少在某些情况下，黄斑前膜剥除的IMH手术可能会对黄斑造成一定损伤。
