Cytologic analysis in vitreo-retinal surgery

Purpose Proliferative vitreoretinopathy (PVR) is the leading cause of failure in retinal detachment (RD)surgery. The migration of retinal pigment epithelial cells and the proliferation of the extracellular matrix has been associated with PVR. The purpose of this prospective study was to compare the cellular contents of the vitreous of patients undergoing RD surgery with patients scheduled for epiretinal membrane surgery (ERM). Methods The vitreous samples of patients with ERM and RD were obtained at the initial phase of surgery. A immunocytochemical labeling was performed in all cases with AE1/AE3, CD68, Vimentin and GFAP antibodies. The cytological identification was performed by a trained pathologist unaware of immunocytochemical labeling. The concentration of vitreous cells were analyzed semi-quantitatively. Results 14 vitreous samples were analysed, 9 patients with RD and 5 undergoing ERM. In the RD group, the cytological findings correlated with the results of immunolabeling. Hyalocytes (labeled with vimentin only)were present in all cases, more abundant in RD cases. Macrophages (labeled with vimentin and CD68) were found in 10/14 cases. Macrophages were more abundant in RD cases (p<0,05). Only in one case of RD, GFAP positive cells were found, in which PVR was particularly severe. In 6/14 samples, glial cells were identified with AE1/AE3 without difference between RD and epiretinal membrane cases. Conclusion Vitreous changes observed in patients with retinal detachment appear to involve particularly hyalocytes and macrophages, which could be identified with immunolabeling. Interestingly glial cells (GFAP positive)were only present in severe PVR. A link between this cell population in the vitreous and the clinical outcome remains to evaluated in a prospective study.