Rosa R H, Glaser B M, de la Cruz Z, Green W R
Eye Pathology Laboratory, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Am J Ophthalmol. 1996 Dec;122(6):853-63. doi: 10.1016/s0002-9394(14)70382-4.
To study the clinicopathologic features of an untreated macular hole in the right eye and a macular hole in the left eye treated by vitrectomy, application of transforming growth factor-beta 2, and gas tamponade.
The patient, a 73-year-old man with bilateral macular holes, was studied clinically before and after surgical treatment of the macular hole in his left eye. The patient's eyes were obtained postmortem and serially step-sectioned through the macula and optic nerve head for electron microscopy.
Examination of 1-micron thick plastic-embedded sections through the macula of the right eye disclosed a 0.6-mm macular hole with rounded gliotic margins, a thin epiretinal membrane, and parafoveal cystic changes. Examination of 1-micron thick plastic-embedded sections through the macula of the left eye disclosed a 0.25-mm defect in the fovea, which was bridged by glial cells. The glial cells were continuous with a thin hypocellular epiretinal membrane without contraction features on both sides of the defect. The ultrastructural features of the glial cells were consistent with Mueller cells.
Treatment of a macular hole with vitrectomy, transforming growth factor-beta 2, and gas tamponade was followed by complete closure of the macular hole by Mueller cell proliferation.
研究右眼未经治疗的黄斑裂孔以及左眼经玻璃体切割术、应用转化生长因子-β2和气体填充治疗的黄斑裂孔的临床病理特征。
该患者为一名73岁患有双侧黄斑裂孔的男性，在其左眼黄斑裂孔手术治疗前后进行了临床研究。患者的眼睛在死后获取，并通过黄斑和视神经乳头进行连续切片以进行电子显微镜检查。
对右眼黄斑部1微米厚的塑料包埋切片检查发现一个0.6毫米的黄斑裂孔，边缘呈圆形胶质化，有一层薄的视网膜前膜，以及黄斑旁囊性改变。对左眼黄斑部1微米厚的塑料包埋切片检查发现中央凹有一个0.25毫米的缺损，由神经胶质细胞桥接。神经胶质细胞与缺损两侧一层薄的细胞减少的视网膜前膜连续，且无收缩特征。神经胶质细胞的超微结构特征与米勒细胞一致。
玻璃体切割术、转化生长因子-β2和气体填充治疗黄斑裂孔后，米勒细胞增殖使黄斑裂孔完全闭合。
