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[Histopathological study of retrolental membranes secondary to persistent hyperplastic primary vitreous]
1Beijing Institute of Opthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Objective:
To study the pathological characteristics of retrolental membranes (RLMs) secondary to persistent hyperplastic primary vitreous (PHPV), and to discuss the possible pathogenesis of PHPV.
Methods:
Experimental study. Six RLMs obtained from six patients with PHPV during vitrectomy were examined by light microscopy (HE & PAS staining). All of them were observed with proliferating cell nuclear antigen (PCNA) immunostaining, together with collagen I, factor VIII related antigen, smooth muscle actin (SMA), epithelial membrane antigen (EMA), neuron specific enolase (NSE) and glial fibrillary acidic protein (GFAP) staining. Apoptosis were detected by terminal deoxynucleotidyl transferase-mediated deoxyuridine 5-triphosphate nick-end labeling (TUNEL).
Results:
Light microscopy showed that the RLM was a dense connective tissue with numerous inflammatory cells including mast cells and lymphocytes. PAS staining showed that RLMs contained a larger amount of polysaccharides. Histopathology and immunohistochemistry showed that there were vascular channels, smooth muscle cells, nervous cells and epithelial cells scattered in RLMs. Collagen I was the main component of RLMs. PCNA-positive nuclei were widely found in RLMs. TUNEL-positive nuclei were also found in all RLMs, as well as in the posterior subcapsular epithelial cells of lens.
Conclusions:
The cell types of RLMs secondary to PHPV are similar to those of the primary vitreous. It is possible that the mechanism of the progression of RLMs is the over-development and incomplete regression of the retrolental vascular system. Inflammation may play an important role in the regression of RLMs.
Insights
Retrolental membranes (RLMs) in persistent hyperplastic primary vitreous (PHPV) contain diverse cell types and vascular channels. Inflammation and over-development of the retrolental vascular system may drive RLM progression.
Area of Science:
- Ophthalmology
- Pathology
- Cell Biology
Context:
- Persistent hyperplastic primary vitreous (PHPV) is a congenital anomaly causing visual impairment.
- Retrolental membranes (RLMs) are a significant complication of PHPV, necessitating surgical intervention.
- Understanding the pathological basis of RLMs is crucial for managing PHPV.
Purpose:
- To elucidate the pathological characteristics of retrolental membranes (RLMs) in persistent hyperplastic primary vitreous (PHPV).
- To investigate the cellular composition and extracellular matrix of RLMs using advanced histological techniques.
- To explore the potential pathogenetic mechanisms underlying RLM formation and progression in PHPV.
Summary:
- Light microscopy and immunohistochemistry revealed RLMs as dense connective tissue with inflammatory cells, vascular channels, smooth muscle, neural, and epithelial cells.
- Collagen I was identified as the primary component, with significant polysaccharide content.
- Proliferating cell nuclear antigen (PCNA) and TUNEL staining indicated active cell proliferation and apoptosis within RLMs.
Impact:
- The findings suggest that RLMs share cellular similarities with the primary vitreous.
- The study proposes that aberrant development and incomplete regression of the retrolental vascular system contribute to RLM progression.
- Inflammation is implicated as a key factor in the regression of RLMs, offering potential therapeutic insights.
