Department of Ophthalmology, San Juan University Hospital, N-332, S/NSant Joan d'Alacant, 03550, Alicante, Spain.
Department of Optics, Pharmacology and Anatomy, University of Alicante, Crta San Vicente del Raspeig S/NSan Vicente del Raspeig, 03690, Alicante, Spain.
Graefes Arch Clin Exp Ophthalmol. 2024 May;262(5):1443-1453. doi: 10.1007/s00417-023-06366-w. Epub 2024 Jan 10.
The main purpose of this study was to perform an immunohistochemical, functional, and anatomical evaluation of patients with idiopathic epiretinal membrane (ERM).
Twenty-four specimens of idiopathic ERM from 24 consecutive patients who underwent 23 G pars plana vitrectomy for ERM and internal limiting membrane (ILM) peeling at the San Juan University Hospital in Alicante (Spain) in 2019 were analyzed. All patients underwent a complete ophthalmological examination including measurement of best corrected visual acuity (BCVA) and macular analysis by spectral-domain optical coherence tomography (SD-OCT) at the time of diagnosis and 3 months after surgery. Specific glial fibrillar acid protein antibodies (GFAP) and S100 calcium-binding protein β (S100β) immunostaining markers were used to identify the macroglial component of the ERM, Müller cells, and astrocytes. Ionized calcium-binding adapter molecule 1 protein (Iba1) antibodies were used as specific markers for inflammatory cells, such as microglia and macrophages.
Mean preoperative BCVA measured with Snellen chart was 0.3 and 0.6 preoperatively and at 3 months after surgery, respectively. SD-OCT identified 15 patients (62.5%) with a disruption of the outer retinal hyperreflective bands. The immunohistochemical study showed the presence of Müller cells in almost all cases (91.6%), as well of abundant microglia and macrophages. Microglia and macrophages were more frequently present in earlier stages of ERM. Microglia were present in ERM independently of the outer retinal hyperreflective bands integrity as measured by SD-OCT. A greater presence of macrophages was found in those ERMs with no outer retinal hyperreflective band disruption.
Müller cells seem to be the most frequent cell group in ERMs, with also presence of microglia cells and macrophages. Astrocytes were more frequently found in early stages of ERMs. Microglia and macrophages were most frequent in ERMs with early stage (1, 2, or 3) than in advanced stages (4).
本研究的主要目的是对特发性视网膜内表面膜（ERM）患者进行免疫组织化学、功能和解剖评估。
分析了 2019 年在西班牙阿利坎特圣胡安大学医院接受 23G 经睫状体平坦部玻璃体切除术联合内界膜（ILM）剥除术治疗 ERM 的 24 例特发性 ERM 患者的 24 个标本。所有患者均接受全面眼科检查，包括在诊断时和术后 3 个月时通过频域光学相干断层扫描（SD-OCT）测量最佳矫正视力（BCVA）和黄斑分析。使用特定的神经胶质纤维酸性蛋白抗体（GFAP）和 S100 钙结合蛋白β（S100β）免疫染色标志物来识别 ERM 的巨胶质细胞成分、Müller 细胞和星形胶质细胞。离子钙结合接头蛋白 1 抗体（Iba1）被用作炎症细胞（如小胶质细胞和巨噬细胞）的特异性标志物。
用 Snellen 图表测量的平均术前 BCVA 分别为 0.3 和 0.6，术前和术后 3 个月。SD-OCT 发现 15 例（62.5%）患者存在外视网膜高反射带中断。免疫组织化学研究显示，几乎所有病例（91.6%）均存在 Müller 细胞，并且存在大量的小胶质细胞和巨噬细胞。小胶质细胞和巨噬细胞在外膜 ERM 的早期阶段更为常见。小胶质细胞存在于 ERM 中，与 SD-OCT 测量的外视网膜高反射带完整性无关。在外视网膜高反射带无中断的 ERM 中发现了更多的巨噬细胞。
Müller 细胞似乎是 ERM 中最常见的细胞群，也存在小胶质细胞和巨噬细胞。星形胶质细胞在外膜 ERM 的早期阶段更为常见。在外膜 ERM 的早期阶段（1、2 或 3）比在晚期阶段（4）中，小胶质细胞和巨噬细胞更为常见。
