Pathophysiology of Vitreo-Macular Interface
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Persistent vitreo-macular adhesions, vitreoschisis with cortical vitreous remnants on the ILM and epiretinal fibrocellular proliferation are associated with vitreo-macular traction. Whereas age-related posterior vitreous detachment is generally accepted as an important pathogenic factor in the development of vitreo-macular traction, the significance of cellular proliferation and migration is still under debate. In the light of the current literature and in our own experience, epiretinal cell proliferations are an essential part of the pathophysiology of vitreo-macular traction. Both, hyalocyte activation in the vitreous cortex and glial cell activation in retinal layers appear to be initiated by age-related vitreous changes driving cell-mediated traction at the vitreoretinal interface as a prerequisite for the development of vitreo-macular traction disorders.
KeywordsGlial Fibrillary Acidic Protein Macular Hole Internal Limit Membrane Epiretinal Membrane Posterior Vitreous Detachment
We are especially grateful to Anselm Kampik, Professor and Chairman of the Department of Ophthalmology at the Ludwig-Maximilians-University Munich, for his enduring support and contribution to our studies. We also would like to thank Christos Haritoglou for his dedication and continuing collaboration. Regarding electron microscopy, we would like to thank Renate Scheler, Helga Wehnes and Axel K. Walch for their outstanding technical assistance.
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