Epiretinal pathology of diffue diabetic macular edema aociated with vitreomacular traction

Purpoe To invetigate the ultratructure of the vitreomacular interface in patient with diffue diabetic macular edema (DDME) aociated with vitreomacular traction. Deign Laboratory invetigation. Method Fifty-five conecutive patient with DDME underwent vitrectomy with en-bloc removal of the inner limiting membrane (ILM) and epimacular tiue. ix patient were operated on both eye. ixty-one pecimen harveted during vitrectomy were analyzed by electron microcopy. Reult Preoperatively, a thickened premacular cortical vitreou wa preent in 47 eye. Native vitreou collagen with ingle cell interpered within the collagenou layer or a cellular monolayer were the ultratructural feature in thee eye. Twenty-three eye howed an epimacular membrane. In eye with obviou ign of tangential vitreomacular traction, multilayered membrane ituated on a layer of native vitreou collagen were found. Fibroblat and fibrou atrocyte were the predominant cell type; myofibroblat and macrophage were alo preent. ixty of 61 pecimen howed native vitreou collagen covering the ILM. Macular edema reolved in 58 eye and perited in 3 eye. No recurrent fibrocellular proliferation wa oberved during the follow-up period of 18 month (mean, 3 to 56 month). Concluion The vitreomacular interface in eye with DDME i characterized by a layer of native vitreou collagen and a varying cellular component. Tangential vitreomacular traction i aociated with multilayered membrane ituated on a layer of vitreou collagen. Reolution of macular edema doe not depend on the preence and removal of contractile membrane. In eye without tangential traction, complete removal of epimacular tiue alo lead to fluid reorption.