Baudouin C, Brignole F, Bayle J, Fredj-Reygrobellet D, Lapalus P, Gastaud P
Department of Ophthalmology, Saint-Roch Hospital, Nice, France.
Invest Ophthalmol Vis Sci. 1991 Jun;32(7):2065-72.
Proliferative vitreoretinopathy (PVR) is the major cause of failure in retinal detachment surgery. It is characterized by the formation of membranes extending along both surfaces of the detached retina and within the vitreous, but the nature of the growing cells has not yet been determined. Using cytologic and immunocytologic procedures with 13 different monoclonal antibodies directed against Class II histocompatibility antigens and various markers of epithelial and immunocompetent cells, 30 specimens were studied of vitreous or subretinal fluid removed from patients with PVR. Five main types of cells could be identified: heavily pigmented cells, poorly pigmented ones, large totally unpigmented macrophage-resembling ones, smaller unpigmented cells, and lymphocytes. Analysis of intravitreal pigment granules, using autofluorescence by epiillumination and cytologic procedures, showed two different populations of pigmented cells: one with autofluorescent lipofuscin granules and the other with exclusively melanin pigment. Immunostaining procedures confirmed the epithelial nonmacrophage lineage of the intravitreal and subretinal cells because most of these cells were positive for cytokeratin but negative for macrophage markers. In addition, 40-100% of these epithelial-derived cells strongly expressed Class II histocompatibility antigens HLA-DR and -DQ. Lymphocytes were found in 13 specimens; B-cells were seen, but no T-lymphocytes could be identified. These results confirm the involvement of retinal pigment epithelial cells and the strong morphologic changes they undergo during the course of PVR. Moreover, the expression of Class II histocompatibility antigens by the growing cells may be related to inflammatory phenomena, but their eventual role in the development and the extension of periretinal proliferation has not been determined.
增殖性玻璃体视网膜病变（PVR）是视网膜脱离手术失败的主要原因。其特征是在脱离视网膜的两个表面以及玻璃体内形成延伸的膜，但增殖细胞的性质尚未确定。使用针对II类组织相容性抗原以及上皮和免疫活性细胞的各种标志物的13种不同单克隆抗体的细胞学和免疫细胞学法，对从PVR患者中取出的30份玻璃体或视网膜下液标本进行了研究。可识别出五种主要细胞类型：色素沉着严重的细胞、色素沉着较差的细胞、完全无色素的类似巨噬细胞的大细胞、较小的无色素细胞和淋巴细胞。利用落射荧光自体荧光和细胞学方法对玻璃体内色素颗粒进行分析，显示出两种不同的色素沉着细胞群体：一种含有自体荧光脂褐素颗粒，另一种仅含有黑色素。免疫染色方法证实了玻璃体内和视网膜下细胞的上皮非巨噬细胞谱系，因为这些细胞中的大多数细胞角蛋白呈阳性，但巨噬细胞标志物呈阴性。此外，这些上皮来源的细胞中有40 - 100%强烈表达II类组织相容性抗原HLA - DR和 - DQ。在13份标本中发现了淋巴细胞；可见B细胞，但未识别出T淋巴细胞。这些结果证实了视网膜色素上皮细胞的参与以及它们在PVR过程中所经历的强烈形态学变化。此外，增殖细胞表达II类组织相容性抗原可能与炎症现象有关，但其在视网膜周增殖的发生和扩展中的最终作用尚未确定。
