Ultrastructure of epiretinal membrane causing retinal starfold.

Area of Science:

• Ophthalmology
• Pathology
• Retinal Diseases

Background:

• Rhegmatogenous retinal detachment is a serious condition requiring prompt treatment.
• Epiretinal membranes can form after retinal detachment surgery and cause visual complications.
• Retinal starfolds are a specific morphologic change observed in certain retinal conditions.

Observation:

• A distinct posterior retinal starfold was observed in a patient with extensive rhegmatogenous retinal detachment.
• The retina was successfully reattached using a scleral buckling procedure.
• An epiretinal membrane was identified as the cause of the starfold.

Findings:

• The epiretinal membrane was surgically removed via vitreous surgery and analyzed using electron microscopy.
• Clinicopathologic correlation revealed the membrane comprised vitreous collagen, newly formed collagen, and various cell types.
• Identified cells included retinal pigment epithelial (RPE) cells, fibrous astrocytes, and macrophages.

Implications:

• Fibrous astrocytes and some RPE cells contained microfilaments resembling myofibrils.
• These myofibrils may have caused membrane contraction, leading to the observed retinal starfold.
• This study provides the first clinicopathologic correlation of an epiretinal membrane causing a starfold in a human eye.