Immunohistochemical, functional, and anatomical evaluation of patients with idiopathic epiretinal membrane
Julio Cesar Molina Martín1, Laura Fernández Sánchez2, David P Piñero3
1Department of Ophthalmology, San Juan University Hospital, N-332, S/NSant Joan d'Alacant, 03550, Alicante, Spain. jcmm.molina@gmail.com.
Insights
This study evaluated idiopathic epiretinal membranes (ERM), finding Müller cells are most common, alongside microglia and macrophages, which are more prevalent in early ERM stages. Visual acuity improved significantly after surgery.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Cell Biology
Background:
- Idiopathic epiretinal membrane (ERM) is a common condition affecting the macula.
- Understanding the cellular composition of ERMs is crucial for diagnosis and treatment.
Purpose of the Study:
- To conduct an immunohistochemical, functional, and anatomical evaluation of idiopathic epiretinal membranes (ERM).
- To identify specific cell types and their distribution within ERM specimens.
Main Methods:
- Analysis of 24 idiopathic ERM specimens obtained during pars plana vitrectomy.
- Immunohistochemical staining using antibodies for glial fibrillar acid protein (GFAP), S100 calcium-binding protein β (S100β), and ionized calcium-binding adapter molecule 1 protein (Iba1).
- Ophthalmological examination including best corrected visual acuity (BCVA) and spectral-domain optical coherence tomography (SD-OCT) before and after surgery.
Main Results:
- Müller cells were present in 91.6% of ERM specimens.
- Abundant microglia and macrophages were observed, with higher prevalence in earlier ERM stages.
- Outer retinal hyperreflective band disruption was identified in 62.5% of patients.
Conclusions:
- Müller cells are the predominant cell type in idiopathic ERMs.
- Microglia and macrophages are significant components, particularly in early-stage ERMs.
- Astrocytes were also found, more frequently in early ERM stages.
Purpose:
The main purpose of this study was to perform an immunohistochemical, functional, and anatomical evaluation of patients with idiopathic epiretinal membrane (ERM).
Methods:
Twenty-four specimens of idiopathic ERM from 24 consecutive patients who underwent 23 G pars plana vitrectomy for ERM and internal limiting membrane (ILM) peeling at the San Juan University Hospital in Alicante (Spain) in 2019 were analyzed. All patients underwent a complete ophthalmological examination including measurement of best corrected visual acuity (BCVA) and macular analysis by spectral-domain optical coherence tomography (SD-OCT) at the time of diagnosis and 3 months after surgery. Specific glial fibrillar acid protein antibodies (GFAP) and S100 calcium-binding protein β (S100β) immunostaining markers were used to identify the macroglial component of the ERM, Müller cells, and astrocytes. Ionized calcium-binding adapter molecule 1 protein (Iba1) antibodies were used as specific markers for inflammatory cells, such as microglia and macrophages.
Results:
Mean preoperative BCVA measured with Snellen chart was 0.3 and 0.6 preoperatively and at 3 months after surgery, respectively. SD-OCT identified 15 patients (62.5%) with a disruption of the outer retinal hyperreflective bands. The immunohistochemical study showed the presence of Müller cells in almost all cases (91.6%), as well of abundant microglia and macrophages. Microglia and macrophages were more frequently present in earlier stages of ERM. Microglia were present in ERM independently of the outer retinal hyperreflective bands integrity as measured by SD-OCT. A greater presence of macrophages was found in those ERMs with no outer retinal hyperreflective band disruption.
Conclusions:
Müller cells seem to be the most frequent cell group in ERMs, with also presence of microglia cells and macrophages. Astrocytes were more frequently found in early stages of ERMs. Microglia and macrophages were most frequent in ERMs with early stage (1, 2, or 3) than in advanced stages (4).
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