黄斑表面膜的分层结构

目的研究孔源性视网膜脱离患者黄斑表面膜(macular pucker,MP )的超微结构，探讨MP的发生机制。方法13例孔源性视网膜脱 离患者的20块MP通过玻璃体手术获取，根据剥膜时所处的上下层位置分为靠近玻璃体一面膜和紧贴视网膜面膜，二个位置膜组织进行对比性透射电镜观察。结果7块近玻璃体的MP以大 量胶原纤维为主，分布的细胞是一些上皮样细胞，胞浆可含有色素颗粒；13块近视网膜面MP 有大量足突细胞，其周围胶原丰富，细胞数量和类型增多，包括典型的成纤维样细胞和神经胶质样细胞。结论视网膜脱离术后MP的组织结构表现层次上差异；玻璃体后界膜积极参与MP的形成；研究提示玻璃体后界膜在黄斑部粘连是发生继发性MP 的一个原因。临床表现，患者通常为不完全性玻璃体后脱离。(中华眼底病杂志,2001,17:52-54)

Ultrastructural characterization of macular pucker

Objective To study the ultrastructure of macular pucker (MP) from the patients with rhegmatogenousretinal detachment (RRD) and the mechanism associated with its development. Methods Twenty specimens of MP surgically removed by vitrectomy from 13 patients were dissected into two layers in each of them.The ultrastructure of two layers,i,e,near the vitreous and near the retina,was studied with electron microscopy. Results Seven sections of the near vitreous ones appeared prodominant collagen deposits and a few of epithelial-like cells,and pigment particles might be present in the cytoplasm.While cells with foot processes were found in 13 membrane sections near the retina and increasing number of various types of cells rich in collagen around were observed including fibroblast-like cells and glial cells. Conclusion The findings suggest that the MP after surgery of retinal detachment may possess a characteristic lamination,and posterior hyaloid cortex was involved in the developmetn of MP.The adhesion between posterior hyaloid cortex and macular area might be a key factor for forming MP.