Ultratructure of the Vitreomacular Interface in Full-Thickne Idiopathic Macular Hole: A Conecutive Analyi of 100 Cae

Purpoe To evaluate the ultratructure of the vitreoretinal interface in tage III and tage IV idiopathic macular hole. Deign A conecutive obervational cae erie, laboratory invetigation. Method Par plana vitrectomy with en-bloc removal of the internal limiting membrane (ILM) and epimacular tiue wa performed by one urgeon in 80 eye with tage III macular hole and in 20 eye with tage IV macular hole. In total, 218 pecimen were proceed for light and tranmiion electron microcopy. Reult Fibrocellular proliferation at the vitreal ide of the ILM wa found in 57 cae. Native vitreou collagen (NVC) wa attached to the ILM in 36 eye. The preence of NVC wa coniderably more frequent in eye with tage IV (70%) than in eye with tage III macular hole (26%). Mono- and multilayered cellular membrane were een more frequently in tage IV macular hole. NVC, if preent, wa alway aociated with fibrocellular proliferation. In 39 eye with tage III and in four eye with tage IV macular hole, the ILM wa devoid of any cell and collagen. Concluion Fibrocellular proliferation appear to be a econdary event intead of a primary feature in macular hole development. The everity of fibrocellular proliferation i aociated with the preence of NVC. Incomplete vitreoretinal eparation may contribute to the development of epimacular membrane in eye with idiopathic macular hole. Remnant of the vitreou cortex remain more often attached to the ILM in eye with pontaneou poterior vitreou detachment (PVD) than in eye with urgical PVD induction.