Sebag J
VMR Institute for Vitreous Macula Retina, 7677 Center Avenue, suite 400, 92647, Huntington Beach, California, USA,
Ophthalmologe. 2015 Jan;112(1):10-9. doi: 10.1007/s00347-014-3048-6.
The vitreoretinal interface consists of the inner limiting membrane of the retina, the posterior vitreous cortex, and an intervening extracellular matrix. Hyalocytes are mononuclear phagocytes embedded in the posterior vitreous cortex, in a single layer of sparse density. At the macula, anomalous posterior vitreous detachment (PVD) results in either full-thickness vitreous cortex adhesion with vitreomacular traction syndrome, or partial-thickness adhesion due to vitreoschisis, a split in the posterior vitreous cortex. Anomalous PVD with vitreoschisis splitting behind the level of the monolayer of hyalocytes leaves a relatively thin hypocellular membrane attached to the macula. Vitreoschisis anterior to the level of the hyalocytes leaves a thicker cellular membrane. Persistent vitreopapillary adhesion promotes outward (from the fovea) tangential traction and is therefore associated with macular holes. Inward (centripetal) tangential traction results in macular pucker, almost always in the absence of persistent vitreopapillary adhesion. The English full-text version of this article is available at SpringerLink (under supplemental).
玻璃体视网膜界面由视网膜内界膜、玻璃体后皮质和其间的细胞外基质组成。玻璃体细胞是嵌入玻璃体后皮质的单核吞噬细胞,呈单层稀疏分布。在黄斑区,异常的玻璃体后脱离(PVD)可导致玻璃体后皮质全层与玻璃体黄斑牵引综合征粘连,或因玻璃体劈裂(玻璃体后皮质的分裂)导致部分厚度粘连。伴有玻璃体劈裂且劈裂位于玻璃体细胞单层水平后方的异常PVD会在黄斑区留下一层相对较薄的低细胞层膜。玻璃体细胞单层水平前方的玻璃体劈裂会留下一层较厚的细胞层膜。持续的玻璃体视乳头粘连会促进向外(从中央凹)的切线牵引,因此与黄斑裂孔相关。向内(向心)的切线牵引会导致黄斑皱襞,几乎总是在没有持续玻璃体视乳头粘连的情况下发生。本文的英文全文版本可在SpringerLink(补充材料中)获取。