Description
Introduction
The commonest cause of failure in retinal reattachment surgery is the anomalous wound healing process called proliferative vitreoretinopathy (PVR). The development of measures to improve outcomes depends on an understanding of the cellular mechanisms involved.
Methods
We imaged retinectomy tissue from eyes of three patients with recurrent retinal detachment associated with PVR grade C using highly multiplexed immunohistochemistry (IBEX). Bright field imaging was utilised to visualise pigmented cells. Equivalent tissue from the retina of an eye unaffected by retinal detachment was used as a normal control.
Results
There was significant disorganisation of retinal structure. Within the retina, there was evidence of ganglion cell neurites extending beyond the outer nuclear layer. The reactive Müller cell and astrocyte marker, GFAP was substantially upregulated in the inner retina with extensive horizontal fibres. Similarly, vimentin also representing Müller glia was upregulated in the inner retina. A discontinuous collagen I/III-positive fibrillary membrane lined the surface of the inner retina, co-localising with the collagen IV-positive internal limiting membrane. There was also evidence of extracellular matrix components, fibronectin and laminin.
Epiretinal membranes had pigmented cells visualised on bright field imaging. These membranes encompassed vimentin-positive and αSMA-positive cells, as well as aforementioned extracellular matrix components.
Conclusion
Epiretinal PVR membranes were comprised of reactive glial cells, fibroblasts and scattered pigment-laden cells alongside extracellular matrix components. IBEX offers a potentially powerful new technique to study PVR in retinectomy tissue.
Lay Abstract
Introduction
Retinal detachment causes loss of vision. Whilst surgery can fix most, some patients suffer from recurrent retinal detachments secondary to processes involving scarring of the retina. Identifying the cells involved in this scarring process can be used to target future treatments.
Methods
We imaged retina samples donated by patients undergoing recurrent retinal detachment surgery using specialised method involving immune markers and fluorescence microscopy. This allowed us to study numerous cells and their arrangement in one given tissue. Three tissue samples were compared with normal control retina samples.
Results
We showed that the retinal cells are highly disorganised following recurrent retinal detachment secondary to scarring processes. Moreover, we focus on the cells involved in the scar tissue itself, namely reactive glial cells, fibroblasts and pigment-laden cells.
Conclusion
This multiple immune marker method using fluorescence microscopy offers a potentially powerful new technique to study the anomalous scarring associated with retinal detachment thereby highlighting potential therapeutic targets for the future.
| Lay Title | Cell arrangement in retinal scarring after retinal detachment. |
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| Role | PhD Student |