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Ultrastructural analyses of internal limiting membrane excised from highly myopic eyes with myopic traction maculopathy

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Abstract

Purpose

To evaluate the ultrastructure of the internal limiting membranes (ILMs) excised during vitrectomy from highly myopic eyes with myopic traction maculopathy (MTM). The clinical findings before and after the vitrectomy were compared.

Methods

Seven eyes of 7 patients with macular retinoschisis were studied. Four of these eyes also had a foveal detachment but without a retinal break. All the eyes underwent vitrectomy with the creation of a posterior vitreous detachment and ILM peeling. The excised ILMs were examined by transmission electron microscopy (TEM).

Results

The retinas were reattached in all eyes after the vitrectomy. No retinal breaks including macular holes were identified intraoperatively. Transmission electron microscopy showed glial cells in 4 eyes, retinal pigment epithelium-like cells in 4 eyes, and myofibroblast-like cells in 4 eyes on the excised ILMs. A newly produced basement membrane appeared to merge with the ILM in 5 eyes. Thick collagen was seen in 2 eyes, and fibrous long-spacing collagen in the newly synthesized collagen fibers was seen in 3 eyes. The cellular components of the glial cells appeared to have migrated through the thinner parts of the retina or through a defect of the ILM in 2 eyes.

Conclusions

Cells that migrate onto the surface of the ILM synthesize new collagen, which can create tangential traction. This may explain the success of vitrectomy with ILM peeling in treating MTM in highly myopic eyes.

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Author information

Authors and Affiliations

  1. Kyorin Eye Center, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan

    Reiji Yokota, Akito Hirakata, Kazunari Hirota, Tosho Rii, Yuji Itoh, Tadashi Orihara & Makoto Inoue

  2. Department of Ophthalmology, Satsukikai Suzaki Kuroshio Hospital, Kochi, Japan

    Nobutsugu Hayashi

Authors
  1. Reiji Yokota
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  2. Akito Hirakata
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  3. Nobutsugu Hayashi
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  4. Kazunari Hirota
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  5. Tosho Rii
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  6. Yuji Itoh
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  7. Tadashi Orihara
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  8. Makoto Inoue
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Corresponding author

Correspondence to Akito Hirakata.

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Conflicts of interest

R. Yokota, None; A. Hirakata, Research fund (Santen), Lecture fees (Alcon lab, Bayer, Kowa, Novartis, Santen, Sanwakagaku, Senjyu); N. Hayashi, None; K. Hirota, None; T. Rii, None; Y. Itoh, Research fund (Bayer), Lecture fees (Alcon lab, Bayer, Novartis, Santen); T. Orihara, None; M. Inoue, Lecture Fee (Alcon lab, Bayer, Carl Zeiss Meditec, Novartis, Santen, Sanwakagaku, Senjyu, Wakamoto).

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Yokota, R., Hirakata, A., Hayashi, N. et al. Ultrastructural analyses of internal limiting membrane excised from highly myopic eyes with myopic traction maculopathy. Jpn J Ophthalmol 62, 84–91 (2018). https://doi.org/10.1007/s10384-017-0542-9

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  • DOI: https://doi.org/10.1007/s10384-017-0542-9

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