Abstract

P 096

Retinal surface wrinkling with glial cell proliferation underneath the internal limiting membrane

Schumann R. G., Haritoglou C., Kampik A., Gandorfer A.
University Eye Hospital, Ludwig-Maximilians-University, Munich

Objective: To report the location of glial cell proliferation at the retinal side of the internal limiting membrane (ILM) in idiopathic surface wrinkling maculopathy.
Methods: A 70-year-old female with deterioration of best visual acuity to 20/50 in the right eye and metamorphopsia in the Amsler chart was found with retinal folds by biomicroscopy. The patient underwent pars plana vitrectomy with ILM removal for surface wrinkling maculopathy. The tissue of ILM peeling was processed for series-sectioning in transmission electron microscopy.
Results: Ultrastructural analysis revealed extensive folding of the ILM and distinct cellular proliferation at the retinal side of the ILM. Cells were exclusively of glial origin, characterized by massive accumulation of intracytoplasmatic intermediate filaments. Glial cells presented as mono- or multilayered proliferation, and were also found in ILM folds. At the vitreal side of the ILM there was no epiretinal cellular proliferation. A continuous layer of native vitreous collagen was present only.
Conclusions: To our knowledge, ultrastructural confirmation of sub-ILM glial cell proliferation in a patient with common clinical features of idiopathic surface wrinkling retinopathy has not been previously reported. Glial cell proliferation underneath the ILM appears to exert tangential stress contributing to the formation of retinal folds. The absence of epiretinal cellular proliferation suggests that glial cells had not yet gained access to the innermost retinal surface in this case.

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