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dell'Omo R, Cucciniello P, Affatato M, Rapino G, D'Albenzio A, Venturi F, Campagna G. Influence of Vitreous Cortex Remnants on Normal Retinal Anatomy in Eyes with Primary Rhegmatogenous Retinal Detachment. Ophthalmol Retina 2024:S2468-6530(24)00190-8. [PMID: 38657953 DOI: 10.1016/j.oret.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To investigate the influence of vitreous cortex remnants (VCRs) removal on normal retinal anatomy in eyes with rhegmatogenous retinal detachment (RRD). DESIGN Prospective cohort study. SUBJECTS Patients with primary RRD operated with pars plana vitrectomy (PPV). METHODS Blue fundus autofluorescence and spectral-domain OCT were obtained preoperatively, and at 1 and 6 months after operation. MAIN OUTCOME MEASURES Primary outcomes: rate of retinal displacement and outer retinal folds (ORFs) at 1 month after operation. SECONDARY OUTCOMES continuity of the external limiting membrane (ELM) and ellipsoid zone (EZ), and the logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) at 6 months after operation. RESULTS One hundred three eyes were included. Intraoperatively, peripheral VCRs (pVCRs) were found in 42 eyes (40.8%) and successfully peeled off from ≥2 quadrants in 37 eyes. Macular VCRs (mVCRs) were detected in 37 (35.9%) and successfully peeled off in 29 eyes. At the end of operation 44.7% and 55.3% of the eyes were tamponaded with 20% sulfur hexafluoride gas and silicone oil 1000 centistokes, respectively. The only variable significantly associated with displacement was the use of gas tamponade versus silicone oil (P = 0.001), whereas no significant association was found between retinal displacement and pVCRs (P = 0.58) or number of quadrants from which pVCRs were peeled off (P = 0.39). At 1 month postoperatively, ORFs were globally detected in 24 eyes (23.3%). Regression analysis showed a direct correlation between ORFs and the intraoperative detection of mVCRs (P = 0.02) and an indirect correlation between ORFs and mVCRs peeling (P = 0.004). Macular VCRs peeling did not influence the continuity of ELM and EZ at the 6-month follow-up (FU). Intraoperative absence of mVCRs (P = 0.0016) and peeling of mVCRs (P = 0.003) were associated with logMAR BCVA ≤0.3 at the 6-month FU. CONCLUSIONS Peeling of pVCRs did not seem to influence the rate of retinal displacement, whereas peeling of mVCRs was associated with a reduced risk of developing ORFs without detrimental effect on the continuity of ELM/EZ at 6-month FU. The patients without mVCRs detected intraoperatively, or who underwent mVCRs peeling during operation, showed a significantly better visual acuity at the 6-month FU. FINANCIAL DISCLOSURE(S) The authors have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Roberto dell'Omo
- Department of Medicine and Health Sciences "V. Tiberio" University of Molise, Campobasso, Italy.
| | - Pasquale Cucciniello
- Department of Medicine and Health Sciences "V. Tiberio" University of Molise, Campobasso, Italy
| | - Marzia Affatato
- Department of Medicine and Health Sciences "V. Tiberio" University of Molise, Campobasso, Italy
| | - Giuseppe Rapino
- Department of Medicine and Health Sciences "V. Tiberio" University of Molise, Campobasso, Italy
| | - Andrea D'Albenzio
- Department of Medicine and Health Sciences "V. Tiberio" University of Molise, Campobasso, Italy
| | - Federico Venturi
- Department of Medicine and Health Sciences "V. Tiberio" University of Molise, Campobasso, Italy
| | - Giuseppe Campagna
- Department of Medical-Surgical Sciences and Translational Medicine, University of Rome "La Sapienza", Rome, Italy
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van Overdam KA, van Etten PG, Accou GPBM, Wubbels RJ, van Meurs JC, Verhoekx JSN. Prevalence of vitreoschisis-induced vitreous cortex remnants over the peripheral retinal surface in eyes undergoing vitrectomy for primary rhegmatogenous retinal detachment. Acta Ophthalmol 2024; 102:99-106. [PMID: 37133363 DOI: 10.1111/aos.15687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 04/10/2023] [Accepted: 04/21/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE Unremoved vitreoschisis-induced vitreous cortex remnants over the peripheral retinal surface posterior to the vitreous base (pVCR) may increase the risk of surgical failure after primary rhegmatogenous retinal detachment (RRD) repair. The purpose of this study was to validate our previous findings on pVCR prevalence during vitrectomy for RRD and to examine their association with proliferative vitreoretinopathy (PVR) and surgical failure. METHODS Prospective observational multisurgeon study of 100 eyes of 100 consecutive patients who underwent vitrectomy for RRD by one of four vitreoretinal surgeons. Collected data included detected pVCR and known PVR risk factors. Pooled analysis with our previous retrospective study (251 eyes of 251 patients) was also performed. RESULTS Initial PVR (≥C) was present and removed in 6/100 (6%) patients, pVCR were detected in 36/100 (36%) patients, pVCR were removed in 30/36 (83%) patients with pVCR, and 4/36 (11%) patients with pVCR were high myopes (≤-6D). Six per cent (6/100) developed a retinal redetachment, of which 3/6 (50%) had initial PVR (≥C). Surgical failure rates in eyes with and without pVCR were 17% (6/36) and 0% (0/64), respectively. In eyes with pVCR and surgical failure, pVCR were not or not completely removed during the first surgery. Overall analysis showed that pVCR were statistically significantly associated with PVR. CONCLUSIONS This study confirms our previous findings: a pVCR prevalence of around 35% and an association between pVCR, PVR formation and surgical failure in patients undergoing vitrectomy for RRD. More research is needed to determine which patients would benefit most from pVCR removal.
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Affiliation(s)
- Koen A van Overdam
- Department of Vitreoretinal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Peter G van Etten
- Department of Vitreoretinal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Geraldine P B M Accou
- Department of Vitreoretinal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - René J Wubbels
- Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
| | - Jan C van Meurs
- Department of Vitreoretinal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Jennifer S N Verhoekx
- Department of Vitreoretinal Surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
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Hwang SH, Lee DY, Nam DH. Vitreous Cortex Remnants Removal With Beveled Vitrectomy Probe During Vitrectomy For Primary Rhegmatogenous Retinal Detachment. Retina 2023; 43:2173-2176. [PMID: 36913622 DOI: 10.1097/iae.0000000000003779] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
PURPOSE To introduce a new surgical technique with a beveled vitrectomy probe for the removal of peripheral vitreous cortex remnants (VCR) in primary rhegmatogenous retinal detachment (RRD). METHODS This study was a retrospective case series. From September 2019 to June 2022, 54 patients with complete or partial posterior vitreous detachment who underwent vitrectomy for primary RRD by a single surgeon were enrolled. RESULTS After staining the vitreous with triamcinolone acetonide, the presence of VCR was assessed in detail. If VCR were present, the macular VCR were removed using surgical forceps, and then, a free flap of peripheral VCR was used as a handle for removing peripheral VCR using the beveled vitrectomy probe. Of the total patients, the presence of VCR was confirmed in 16 patients (29.6%). There were no intraoperative or postoperative complications, except for retinal redetachment caused by proliferative vitreoretinopathy, that occurred in only one eye (1.9%). CONCLUSION Using a beveled vitrectomy probe was a practical solution for removing VCR during RRD vitrectomy because additional instruments were not needed and risk of iatrogenic retinal damage was low.
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Affiliation(s)
- Sung Ha Hwang
- Department of Ophthalmology, Gil Medical Center, College of Medicine, Gachon University, Incheon, Korea
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dell'Omo R, Carosielli M, Rapino G, Affatato M, Cucciniello P, Virgili G, Filippelli M, Costagliola C, Campagna G. Biomarkers of Vitreous Cortex Remnants in Eyes With Primary Rhegmatogenous Retinal Detachment. Transl Vis Sci Technol 2023; 12:24. [PMID: 37367719 DOI: 10.1167/tvst.12.6.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
Purpose The purpose of this study was to identify pre-operative biomarkers of vitreous cortex remnants (VCRs) in eyes with rhegmatogenous retinal detachment (RRD). Methods Prospective case series of 103 eyes treated with pars plana vitrectomy (PPV) to repair RRD. Pre-operatively, optical coherence tomography (OCT) and B-scan ultrasonography (US) were used to study the vitreo-retinal interface and vitreous cortex status. If detected during PPV, VCRs were removed. Images acquired pre-operatively were compared with intra-operative findings and with postoperative OCT images taken at 1, 3, and 6 months of follow-up. Multivariate regression analyses were performed to determine associations between VCRs and pre-operative variables. Results The presence of VCRs at the macula (mVCRs) and at the periphery (pVCRs), was ascertained intra-operatively in 57.3% and 53.4% of the eyes, respectively. Pre-operatively, a preretinal hyper-reflective layer (PHL) and a saw-toothed aspect of the retinal surface (SRS) were identified with OCT in 73.8% and 66% of the eyes, respectively. US sections showed a vitreous cortex running close and parallel to the detached retina upon static and kinetic examination (the "lining sign") in 52.4% of the cases. Multivariate regression analyses showed an association between PHL and SRS and intra-operative evidence of mVCRs (P = 0.003 and < 0.0001, respectively) and between SRS and "lining sign" and pVCRs (P = 0.0006 and 0.04, respectively). Conclusions PHL and SRS on OCT and the "lining sign" on US appear to be useful pre-operative biomarkers of the intra-operative presence of VCRs. Translational Relevance Preoperative identification of VCRs biomarkers may help to plan the operating strategy in eyes with RRD.
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Affiliation(s)
- Roberto dell'Omo
- Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - Marianna Carosielli
- Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - Giuseppe Rapino
- Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - Marzia Affatato
- Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - Pasquale Cucciniello
- Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - Gianni Virgili
- Eye Clinic, AOU Careggi Teaching Hospital, University of Florence, Florence, Italy
| | - Mariaelena Filippelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - Ciro Costagliola
- Department of Ophthalmology, University of Naples "Federico II," Naples, Italy
| | - Giuseppe Campagna
- Department of Medical-Surgical Sciences and Translational Medicine, University of Rome "Sapienza," Rome, Italy
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Assi A, Mansour AM, Charbaji AR, Battaglia Parodi M. Is There a Link Between Vitreous Cortex Remnants and Anatomic Outcome of Vitrectomy for Primary Rhegmatogenous Retinal Detachment? Clin Ophthalmol 2023; 17:1489-1496. [PMID: 37273502 PMCID: PMC10237278 DOI: 10.2147/opth.s408871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 05/25/2023] [Indexed: 06/06/2023] Open
Abstract
Purpose To study the anatomic outcome of leaving vitreous cortex remnants (VCR) during pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD). Methods The study comprised patients with RRD who had PPV by a single surgeon between January 2019 and December 2020 and followed for 6 months. After intravitreal injection of triamcinolone acetonide, the topographic pattern of VCR at the periphery (p) and macula (m) was divided into 2 types by extent: complete or 4 quadrants (pVCR4Q), and between 2 and 4 quadrants ≥2 quadrants (pVCR>2Q), or by location >1 inferior retinal quadrant (pVCR>1InfQ), and at the macula (mVCR). Anatomical failure or retinal re-detachment within 6 months after surgery was the primary outcome measures. The occurrence of grade C proliferative vitreoretinopathy (PVR) and epiretinal membrane (ERM) were used as secondary outcome indicators. Results A 6-month prospective follow-up was performed on 103 patients. pVCR4Q was detected in 31 eyes, pVCR>2Q in 40 eyes, pVCR>1InfQ in 40 eyes and mVCR in 54 eyes. Recurrent RRD developed in 9 (8.7%) eyes, PVR grade C in 6 (5.8%) eyes and ERM in 11 (10.7%) eyes. According to multivariate regression analysis, the existence of any type of VCR did not correlate with anatomical failure, PVR or ERM. Conclusion The initial success rate of PPV and the growth of PVR or ERM do not appear to be impacted by keeping VCR.
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Affiliation(s)
- Alexandre Assi
- Beirut Eye Clinic and VitreoRetinal Department, Beirut Eye Specialist Hospital, Beirut, Lebanon
| | - Ahmad M Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Abdul Razzak Charbaji
- Department of Statistics and Research Methodology, Lebanese American University, Beirut, Lebanon
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Jiang Y, Liu X, Ye J, Ma Y, Mao J, Feng D, Wang X. Migrasomes, a new mode of intercellular communication. Cell Commun Signal 2023; 21:105. [PMID: 37158915 PMCID: PMC10165304 DOI: 10.1186/s12964-023-01121-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/30/2023] [Indexed: 05/10/2023] Open
Abstract
Migrasomes are newly discovered extracellular vesicles (EVs) that are formed in migrating cells and mediate intercellular communication. However, their size, biological generation, cargo packaging, transport, and effects on recipient cells by migrasomes are different from those of other EVs. In addition to mediating organ morphogenesis during zebrafish gastrulation, discarding damaged mitochondria, and lateral transport of mRNA and proteins, growing evidence has demonstrated that migrasomes mediate a variety of pathological processes. In this review, we summarize the discovery, mechanisms of formation, isolation, identification, and mediation of cellular communication in migrasomes. We discuss migrasome-mediated disease processes, such as osteoclast differentiation, proliferative vitreoretinopathy, tumor cell metastasis by PD-L1 transport, immune cell chemotaxis to the site of infection by chemokines, angiogenesis promotion via angiogenic factors by immune cells, and leukemic cells chemotaxis to the site of mesenchymal stromal cells. Moreover, as new EVs, we propose the potential of migrasomes for disease diagnosis and treatment. Video Abstract.
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Affiliation(s)
- Yuyun Jiang
- Department of Central Laboratory, The Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, China
| | - Xi Liu
- Department of Central Laboratory, The Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, China
| | - Jixian Ye
- Department of Central Laboratory, The Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, China
| | - Yongbin Ma
- Department of Central Laboratory, The Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, China.
- Department of Central Laboratory, Jintan Hospital, Jiangsu University, 500 Avenue Jintan, Jintan, 213200, People's Republic of China.
| | - Jiahui Mao
- Department of Central Laboratory, The Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, China
| | - Dingqi Feng
- Department of Central Laboratory, The Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, China
| | - Xuefeng Wang
- Department of Central Laboratory, The Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, China.
- Department of Nuclear Medicine and Institute of Digestive Diseases, The Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, China.
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Sparks ME, Davila PJ, He YG, Wang AL. Pediatric Rhegmatogenous Retinal Detachments: Etiologies, Clinical Course, and Surgical Outcomes. JOURNAL OF VITREORETINAL DISEASES 2023; 7:139-143. [PMID: 37006670 PMCID: PMC10037755 DOI: 10.1177/24741264221150595] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Purpose: To describe the predisposing factors, clinical course, and surgical methods of pediatric rhegmatogenous retinal detachment (RRD) and determine which factors affect anatomic success. Methods: Data of patients 18 years or younger who had surgical repair for RRD from January 1, 2004, to June 31, 2020, with a minimum of 6 months of follow-up were retrospectively analyzed. Results: The study evaluated 101 eyes of 94 patients. Of the eyes, 90% had at least 1 predisposing factor to pediatric RRD, including trauma (46%), myopia (41%), prior intraocular surgery (26%), and congenital anomaly (23%); 81% had macula-off detachments and 34% had proliferative vitreoretinopathy (PVR) grade C or worse at presentation. The presence of PVR grade C or worse (P = .0002), total RRD (P = .014), and vitrectomy alone at first surgery (P = .0093) were associated with worse outcomes. Patients who had scleral buckle (SB) alone at the first surgery had statistically higher rates of anatomic success than those who had vitrectomy alone or combined with SB (P = .0002). After the final surgery, 74% of patients achieved anatomic success. Discussion: The majority of cases in this study were associated with 1 of the 4 risk factors predisposing to pediatric RRD. These patients often present late with macula-off detachments and PVR grade C or worse. The majority of patients achieved anatomic success after surgical repair using SB, vitrectomy, or a combination.
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Affiliation(s)
- Madeline E. Sparks
- University of Texas Southwestern
Medical Center, Dallas, TX, USA
- Children’s Health, Dallas, TX,
USA
| | - Pedro J. Davila
- University of Texas Southwestern
Medical Center, Dallas, TX, USA
- Children’s Health, Dallas, TX,
USA
| | - Yu-Guang He
- University of Texas Southwestern
Medical Center, Dallas, TX, USA
- Children’s Health, Dallas, TX,
USA
| | - Angeline L. Wang
- University of Texas Southwestern
Medical Center, Dallas, TX, USA
- Children’s Health, Dallas, TX,
USA
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Jones CH, Gui W, Schumann RG, Boneva SK, Lange CAK, van Overdam KA, Chui TYP, Rosen RB, Engelbert M, Sebag J. Hyalocytes in proliferative vitreo-retinal diseases. EXPERT REVIEW OF OPHTHALMOLOGY 2022; 17:263-280. [DOI: 10.1080/17469899.2022.2100764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | - Wei Gui
- VMR Institute for Vitreous Macula Retina, Huntington Beach, California, USA
| | - Ricarda G. Schumann
- Department of Ophthalmology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Stefaniya K. Boneva
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Clemens A. K. Lange
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Ophtha-Lab, Department of Ophthalmology at St. Franziskus Hospital, Muenster, Germany
| | - Koen A. van Overdam
- Department of Vitreo-Retinal surgery, The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Toco Y. P. Chui
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Richard B. Rosen
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Engelbert
- Vitreous Retina Macula Consultants of New York
- NYU School of Medicine, New York, NY, USA
| | - J. Sebag
- VMR Institute for Vitreous Macula Retina, Huntington Beach, California, USA
- Doheny Eye Institute, UCLA, Pasadena, California, USA
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van Overdam KA, van den Bosch TPP, van Etten PG, Uppal GS, Veckeneer M, Verdijk RM. Novel insights into the pathophysiology of proliferative vitreoretinopathy: The role of vitreoschisis-induced vitreous cortex remnants. Acta Ophthalmol 2022; 100:e1749-e1759. [PMID: 35673878 DOI: 10.1111/aos.15197] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 05/22/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE We previously hypothesized a causal relationship between vitreoschisis-induced vitreous cortex remnants (VCR) and the development of proliferative vitreoretinopathy (PVR). This study aims to substantiate this association through histopathological analysis of surgical specimens in support of strategies to improve therapeutic outcomes. METHODS A descriptive, prospective, non-consecutive case series. Histopathological and immunohistochemical analyses were performed on membranes removed from the peripheral retinal surface during initial vitrectomy for primary rhegmatogenous retinal detachment (RRD) (n = 11) or recurrent retinal detachment (n = 12). The clinical aspect of the membranes ranged from loose-meshed membranes visualized with triamcinolone to more fibrotic membranes stained with trypan blue. RESULTS Consistent with the clinical presentation, histopathological analysis revealed membranes with different area characteristics. Paucicellular lamellar collagen-rich areas, suggestive of VCR, appeared to transition to areas of increased cellularity and eventually more fibrotic areas of low cellularity. Five different area characteristics could be identified that seemed to correspond to five histopathological stages in PVR formation, with lamellar VCR collagen acting as an essential precondition: 1. Lamellar collagen, low cellularity (hyalocytes). 2. Lamellar collagen, increased cellularity (hyalocytes, glial cells). 3. Lamellar collagen, high cellularity (macrophages, glial cells, RPE-cells). 4. Early fibrosis, decreased cellularity (myofibroblasts). 5. Fibrosis, low cellularity (myofibroblasts). CONCLUSION These findings confirm the role of VCR in preretinal PVR formation posterior to the vitreous base. We propose that the presence of VCR over the retinal surface should be qualified as a risk factor for PVR formation. Detection and adequate removal of VCR may improve the success rate of vitreoretinal surgeries.
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Affiliation(s)
- Koen A van Overdam
- Department of Vitreoretinal Surgery, the Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Thierry P P van den Bosch
- Department of Pathology, Section Ophthalmic Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Peter G van Etten
- Department of Vitreoretinal Surgery, the Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - Gurmit S Uppal
- Department of Vitreoretinal Surgery, Moreton Eye Group, Brisbane, Queensland, Australia
| | - Marc Veckeneer
- Department of Vitreoretinal Surgery, ZNA Middelheim, Antwerp, Belgium
| | - Robert M Verdijk
- Department of Vitreoretinal Surgery, the Rotterdam Eye Hospital, Rotterdam, The Netherlands.,Department of Pathology, Section Ophthalmic Pathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
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