Vitreoretinal interface features in epiretinal membrane associated with pseudoexfoliation syndrome

Area of Science:

• Ophthalmology
• Vitreoretinal Surgery
• Pathology

Background:

• Pseudoexfoliation syndrome (PEX) is a common condition affecting ocular tissues.
• Epiretinal membranes (ERMs) can form on the retinal surface, causing visual distortion.
• The vitreoretinal interface (VRI) is crucial for retinal health.

Purpose of the Study:

• To compare the histopathology of the VRI in eyes with PEX and ERM (pERM) versus idiopathic ERM (iERM).
• To elucidate the specific molecular and structural differences in ERMs associated with PEX.

Main Methods:

• Surgical specimens of ERM and internal limiting membrane (ILM) were collected from pERM and iERM eyes.
• Immunocytochemistry and transmission electron microscopy (TEM) were used for detailed analysis.
• Cellular and extracellular components were compared and correlated with clinical data.

Main Results:

• pERM specimens showed significantly higher levels of fibrillin-1, collagen IV, and TGFβ1 compared to iERM.
• TEM revealed abundant vitreous collagen and fibrous long-spacing collagen (FLSC) in pERM, absent in iERM.
• Glial markers (GFAP, vimentin) were consistently positive in both groups.

Conclusions:

• Eyes with pERM exhibit excessive extracellular matrix and elastic protein accumulation at the VRI.
• PEX appears to induce distinct pathological changes in the VRI, involving collagen alterations.
• These findings suggest PEX impacts the VRI similarly to its effects on the anterior ocular segment.