1Department of Ophthalmology, Taizhou Hospital of Wenzhou Medical University, Taizhou 317000, China 2Department of Pathology, Taizhou Hospital of Wenzhou Medical University, Taizhou 317000, China
Abstract:Objective: To observe the histopathological structure characteristics and cellular fiber components of the idiopathic epimacular membrane (IMEM) in each stage, thus to study the pathologic development of IMEM. Methods: This is a prospective clinical study. A total of sixty patients (62 eyes) with IMEM who underwent vitrectomy combined with internal limiting membrane and IMEM peeling treatment in Luqiao Branch of Taizhou Hospital from February 2016 to September 2018 were selected. The patients were then divided into 4 groups based on OCT images (stage 1 group to stage 4 group). The IMEM tissues were collected and stained with HE. Further immunohistochemical staining was performed for SMA,GFAP, S-100, CD34 and CD68. And Elastic and Masson staining were conducted as well. The types of IMEM, pathological structural characteristics, cell density, fiber components, and immunohistochemical positive rates were recorded. The Chi-square test was applied to analyze the proportion of IMEM types and immunohistochemical positive rates, while the Kruskal-Wallis H test was utilized to compare cell density. Results: The IMEM could be divided into two types: dense membrane and sparse membrane. The proportion of the two types was statistically different among the groups (χ2=11.44, P=0.006). Under the microscope, it was found that the cell numbers and cell cytoplasm decreased from stage 1 to stage 4, and the collagen fibers in the tissue changed from dense to sparse. The cell density of IMEM in the four groups was also statistically different (H=13.73, P=0.003). Post-hoc analyses found there was a statistical difference in cell density between stage 2 and stage 4 (H=3.69, P=0.001). Immunohistochemical staining showed that CD3 was negative, GFAP was positive, and some membrane tissues expressed SMA, S-100, and C68, however, there was no significant difference in the positive rates among groups. Elastic fiber staining and Masson staining showed that the IMEM fibers were collagen fibers, and the fibers gradually expanded and thickened from stage 1 to stage 4. Conclusion: IMEM was a kind of non-vascular fibroproliferative tissue. Its major cell components were glial cells and fibroblasts. The cell components in each stage were similar, and the fibers were composed of collagen. The cell density decreased and the fibers gradually expanded as the disease developed.
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