Cytopathological findings in the vitreous of patients with retinal detachment

Purpose Proliferative vitreoretinopathy (PVR) is the leading cause of failure in retinal detachment surgery. The migration of retinal pigment epithelial cells and the occurrence of extracellular matrix changes have been associated with PVR. The purpose of this prospective study was to analyze the cellular contents of the vitreous in patients with retinal detachment. Methods The vitreous samples of patients with epiretinal membrane and rhegmatogenous retinal detachment were obtained at the initial phase of surgery without previous intraocular infusion. A cytopathological analysis and staining of the vitreous was performed in all cases. The vitreous of 40 patients with retinal detachment and 49 patients undergoing epiretinal membrane peeling (control group) were included. Results The preparations displayed a variable cellularity. A higher amount of epithelial cell clumping was observed in retinal detachment specimens compared with controls. Furthermore, in the retinal detachment group, more free pigments were encountered and a higher degree of reticulation of the extracellular matrix was noted. In the vitreous of patients with retinal detachment, there is some cytopathological evidence for a higher concentration and an increased activity of retinal pigment epithelial cells compared with controls. Conclusion The predictive value of cytopathological changes for the occurrence of postoperative proliferative vitreoretinopathy in patients undergoing retinal detachment surgery remains to be demonstrated.