Skip to main content
SpringerLink
Log in

Macular holes: migratory gaps and vitreous as obstacles to glial closure

  • Laboratory Investigation
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

• Purpose: Retinal glia may play an important role in the closure of macular holes. This in vitro study examines whether and how the specific pathoanatomy, including foveal eversion and foveal vitreous, may interfere with glial closure of macular holes. • Methods: Culture dishes used to grow glial cells were modified by the placement of slopes, vertical steps, and gaps to mimic the in vivo migratory surface in and surrounding macular holes. In separate experiments, defects were made in a rodent glial monolayer. These defects were exposed to hyaluronic acid (HA) and to rabbit (RV) and bovine (BV) vitreous gel. The migratory behavior and completeness of closure of defects were compared to controls. • Results: As expected, glial cells migrated further and in greater numbers on a smooth surface. Slopes and steps were mode-rate obstacles to migration; gaps in the surface were absolute obstacles. HA modified the pattern of adhesion of cells at the bottom of defects. Defects in the glial monolayer were repaired in 5–7 days. Compared to these controls, repair was inhibited by 11 % (n. s.), 28% (P=0.02), and 58% (P=0.004) after direct exposure of defects to HA, RV and BV respectively. • Conclusion: The elevated and everted margins of macular holes represent slope, step, and gap-like obstacles to the migration of glial cells and hence to the healing of defects. The defect allows extension of extracellular matrix into it and the subretinal space. Our results indicate that gaps in the migratory surface caused and aggravated by eversion and the presence of vitreous present obstacles to glial migration and closure of macular holes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Balazs EA, Darzynkiewicz Z (1973) The effect of hyaluronic acid on fibroblasts, mononuclear phagocytes and lymphocytes. In: Kulonen E, Pikkarainen J (eds) Biology of the fibroblast. Papers of the symposium held in Turku, Finland, 1972. Academic, London, pp 237–252

    Google Scholar 

  2. Balazs EA, Denlinger JL (1984) The vitreous. In: Davson H (ed) The eye, 3rd edn. Academic, New York, pp 533–589

    Google Scholar 

  3. Byer NE (1982) The natural history of asymptomatic retinal breaks. Ophthalmology 80:1033–1039

    Google Scholar 

  4. Dunnington JH (1951) Healing of incisions for cataract extraction. Am J Ophthalmol 34:36–45

    Google Scholar 

  5. Eisner G (1986) Ophthalmic viscosurgery. A review of standards, techniques and applications. Medicoepea, Montreal

    Google Scholar 

  6. Frangieh G, Green W, Engel H (1981) A histopathologic study of macular cysts and holes. Retina 1:311–336

    Google Scholar 

  7. Funata M, Wendel RT, de la Cruz Z, Green RW (1992) Clinicopathologic study of bilateral macular holes treated with pars plana vitrectomy and gas tamponade. Retina 12:289–298

    Google Scholar 

  8. Glaser B, Michels R, Kupperman B, Sjaarda R, Pena R (1992) Transforming growth factor beta 2 for the treatment of full-thickness macular holes. Ophthalmology 99:1162–1173

    Google Scholar 

  9. Gonin J (1934) Decollement de la retine. Librairie Payot, Lausanne

    Google Scholar 

  10. Guerin CJ, Wolfshagen RW, Eifrig DE, Anderson DH (1990) Immunocytochemical identification of Mueller's glia as a component of human epiretinal membranes. Invest Ophthalmol Vis Sci 31:1483–1491

    Google Scholar 

  11. Guyer D, Green W, de Bustros S, Fine S (1990) Histopathologic features of idiopathic macular holes and cysts. Ophthalmology 97:1045–1051

    Google Scholar 

  12. Head M, Corbin E, Goldman J (1994) Coordinate and independent regulation of alpha B-crystallin and HSP27 expression in response to physiological stress. J Cell Physiol 159:41–50

    Google Scholar 

  13. Hogan MJ, Alvarado JA, Weddell JE (1971) Histology of the human eye. Saunders, Philadelphia

    Google Scholar 

  14. Johnson RN, Gass JDM (1988) Idiopathic macular holes. Observations, stages of formation, and implications for surgical intervention. Ophthalmology 95:917–924

    Google Scholar 

  15. Kelly NE, Wendel RT (1991) Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol 109:654–659

    Google Scholar 

  16. Kirchhoff B, Orr G, Ryan SJ, Lean JS (1986) The role of the vitreous and the retina in controlling the transfer of tritiated water from the vitreous cavity to the choroid. Invest Ophthalmol Vis Sci [Suppl] 27:316

    Google Scholar 

  17. Krebs W, Krebs I (1989) Quantitative morphology of the central fovea in the primate retina. Am J Anat 184:225–236

    Google Scholar 

  18. Lewis H, Cowan GM, Straatsma BR (1986) Apparent disappearance of a macular hole associated with development of an epiretinal membrane. Am J Ophthalmol 102:172–175

    Google Scholar 

  19. Madreperla SA, Geiger GL, Funata M, de la Cruz Z, Green WR (1994) Clinicopathologic correlation of a macular hole treated by cortical vitreous peeling and gas temponade. Ophthalmology 101:682–686

    Google Scholar 

  20. Madreperla SA, McCuen BW, Hickingbotham D, Green WR (1995) Clinicopathologic correlation of surgically removed macular hole opercula. Am J Ophthalmol 120:197–207

    Google Scholar 

  21. Mann IC (1928) The development of the human eye. Cambridge University Press, London, p 81

    Google Scholar 

  22. Nao-i N, Nakano T, Sawada A, Ogino N, Tachi N (1996) Effect of removal of the retina] pigment epithelium on postoperative visual recovery after vitrectomy for idiopathic macular holes. Invest Ophthalmol Vis Sci [Suppl] 37:428

    Google Scholar 

  23. Orellana J, Lieberman RM (1993) Stage 3 macular hole surgery. Br J Ophthalmol 77:555–558

    Google Scholar 

  24. Rice RT (1994) Success in macular hole surgery is increased by removal of presumed internal limiting membrane. Annual meeting of the Retina Society, Williamsburg, Virginia, p 61

  25. Thompson JT, Smiddy WE, Glaser BM, Sjaarda RN, Flynn HW (1996) Intraocular tamponade duration and success of macular hole surgery. Retina 16:373–382

    Google Scholar 

  26. Weinberger D, Sticbel H, Gaton DD, Priel E, Yassur Y (1995) Three-dimensional measurements of idiopathic macular holes using a scanning laser tomograph. Ophthalmology 102:1445–1449

    Google Scholar 

  27. Yamada E (1969) Some structural features of the fovea centralis in the human retina. Arch Ophthalmol 82:151–159

    Google Scholar 

  28. Yanoff M, Fine BS (1982) Ocular pathology: a text and atlas, 2nd edn. Harper & Row, Philadelphia

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departmet of Ophthalmoloy, Columbia University, New York, USA

    Herman D. Schubert, Kunyan Kuang, Fengying Kang & Jorge Fischbarg

  2. Department of Pathology, Columbia University, New York, USA

    Herman D. Schubert & Mark W. Head

Authors
  1. Herman D. Schubert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kunyan Kuang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fengying Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark W. Head
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jorge Fischbarg
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schubert, H.D., Kuang, K., Kang, F. et al. Macular holes: migratory gaps and vitreous as obstacles to glial closure. Graefe's Arch Clin Exp Ophthalmol 235, 523–529 (1997). https://doi.org/10.1007/BF00947011

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00947011

Keywords

Search

Navigation