Age-Related Cellular Proliferation at the Vitreoretinal Juncture

Summary Clinical and pathological features of non-vascularised epiretinal membranes are reviewed with special attention to focal epimacular tractional lesions in the elderly. The role of immunohistochemi stry in elucidating the nature of component cells of complex epiretinal membranes is emphasised. Clinicopathologi cal correlation establishes the 'fibroglial membrane' as the causative lesion of age-related epimacu­ lar traction. The pathogenesis of this process is discussed, including relevant animal models, and chronic inflammation and ischaemia (rather than acute posterior vitreous detachment) are implicated. Vitrectomy and epimacular membrane peel­ ing results in significant visual improvement in most patients. The formation of a cellular epiretinal mem­ brane (ERM) in the posterior part of the fun­ dus, with subsequent contraction and exertion of tangential traction on the retina, is an important problem in the elderly. Such focal fibrocellular proliferations represent part of the spectrum of so-called 'non-vascular proliferative extraretinopathi