Baudouin C, Hofman P, Brignole F, Bayle J, Loubière R, Gastaud P
Department of Ophthalmology, Saint-Roch Hospital, Nice, France.
Ophthalmologica. 1991;203(1):38-46. doi: 10.1159/000310223.
Proliferative vitreoretinopathy accounts for most of failures in retinal detachment surgery. It results from the formation of membranes spreading onto inner and outer surfaces of the detached retina and within the vitreous body, but the nature of the growing cells and the mechanisms of proliferation remain speculative. A cytological study was thus undertaken on 35 specimens of vitreous and subretinal fluid obtained surgically in patients with proliferative vitreoretinopathy. Various types of cells were identified: typical pigment epithelial cells, lightly pigmented and large totally unpigmented macrophage-resembling cells, smaller unpigmented cells and lymphocytes. Immunocytological procedures with 10 different monoclonal antibodies directed against different markers of epithelial and immunocompetent cells showed the epithelial nonmacrophagic origin of the intravitreal and subretinal cells, as most of these cells were positive for cytokeratin but remained negative for macrophage markers. Examination of intravitreal pigment granules, using autofluorescence analysis by epi-illumination and toluidine blue staining, showed two distinct populations of pigmented cells, one containing melanin and the other lipofuscin, suggesting that pigmented cells could originate from the retinal and ciliary pigment epithelia. As concerns lymphocyte identification, only B cells were seen, whereas no T lymphocyte could be found. Fibronectin was found on a minority of cells in 4 vitreous specimens, but cells positive for glial fibrillary acidic protein could not be seen. These results confirm the involvement of pigment epithelial cells and the strong morphological changes they undergo during the course of proliferative vitoretinopathy, but the mechanisms of proliferative phenomena after retinal detachment remain to be determined.
增殖性玻璃体视网膜病变是视网膜脱离手术失败的主要原因。它是由蔓延至脱离视网膜内、外表面及玻璃体内的膜形成所致，但生长细胞的性质和增殖机制仍存在推测性。因此，对35例增殖性玻璃体视网膜病变患者手术获取的玻璃体和视网膜下液标本进行了细胞学研究。识别出了多种类型的细胞：典型色素上皮细胞、色素淡且大的完全无色素的类巨噬细胞、较小的无色素细胞和淋巴细胞。用针对上皮细胞和免疫活性细胞不同标志物的10种不同单克隆抗体进行免疫细胞化学检测显示，玻璃体内和视网膜下细胞起源于上皮而非巨噬细胞，因为这些细胞大多细胞角蛋白呈阳性，但巨噬细胞标志物呈阴性。通过落射荧光分析和甲苯胺蓝染色对玻璃体内色素颗粒进行检查，发现了两种不同的色素细胞群体，一种含黑色素，另一种含脂褐素，提示色素细胞可能起源于视网膜和睫状体色素上皮。关于淋巴细胞识别，仅见B细胞，未发现T淋巴细胞。在4份玻璃体标本中，少数细胞上发现了纤连蛋白，但未见胶质纤维酸性蛋白阳性细胞。这些结果证实了色素上皮细胞的参与以及它们在增殖性玻璃体视网膜病变过程中所经历的强烈形态学变化，但视网膜脱离后增殖现象的机制仍有待确定。
