复杂视网膜脱离视网膜下膜超微结构研究

目的研究复杂视网膜脱离病例中视网膜下膜的超微结构特征,探讨视网膜下膜的细胞成分。方法对21例复杂孔源性视网膜脱离伴视网膜下膜者行玻璃体切割术加视网膜下膜切除术,将所获得的视网膜下膜经处理后于光镜下选择细胞较密集处做超薄切片,染色后行透射电镜观察并摄影。结果复杂视网膜脱离视网膜下膜中,色素上皮细胞多呈散在分布,未见明显基底膜供细胞附着,在条索或片状膜当中的色素上皮细胞形态存在变化。神经胶质细胞胞浆内有较丰富的细胞器和直径约10nm的中间型微丝形成。视网膜下膜的细胞间质含有大量胶原纤维。成纤维细胞形状不规则,活跃,胞浆中见大量直径4～6nm微丝。结论视网膜下膜主要由视网膜色素上皮细胞、神经胶质细胞、成纤维细胞和胶原纤维组成。视网膜下膜中色素上皮细胞、神经胶质细胞和成纤维细胞有转化与增殖能力。

Ultrastructure of subretinal membranes from complex retinal detachment

ObjectiveTo find out the ultrastructure of subretinal membrane in complex retinal detachment cases.MethodsVitrectomy were performed on 21 cases with complicated retinal detachment.The specimens from subretinal membranes were collected during the operation and treated for the examination under the light and transmission electric microscope.ResultsMicrovilli was existed on the surface of pigment epithelial cells in the specimens of subretinal membranes from complex retinal detachment under the light microscope.RPE cell showed a polarity and interspersion arrangement without basilar membrane.There were some thickening pigment granule in the cytosol of RPE.The configuration of RPE was different in the stick or flat of the subretinal membranes.Collagenic fibers,fibroblast,pigment granule of RPE,vacular degenerative chondriosome and membranous disc of RPE were seen in the subretinal membranes.Glial cells had abundant organalle and intermediate type microflament.There were a great deal of collagenic fibers in the martrix among cells.The nucleolus of fibroblast displayed irregular shape and was active with much microflament.ConclusionThe subretinal membranes are major composed of RPE,glial cells,fibroblast and collagen fibers.RPE and glial cells had an ability of conversion and proliferation.