Cytologic analysis in vitreo-retinal surgery

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Abstract

Purpose

Proliferative vitreoretinopathy (PVR) is the leading cause of failure in retinal detachment 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 retinal detachment surgery with patients scheduled for macular surgery.

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 cytological analysis and Papanicolaou staining was performed in all cases. The concentration of vitreous cells in 62 patients with retinal detachment and 62 undergoing macular surgery (52 epiretinal membranes, 6 macular holes and 4 vitreomacular traction syndromes) were analyzed semi-quantitatively.

Results

An increased concentration of vitreous cells and free pigment was observed in a higher proportion in retinal detachment specimens compared with patients undergoing macular surgey. In the retinal detachment group, there was a higher amount of hyalocytes (p=0,017) and macrophages (p=0,00865). There was no correlation between any cell concentration and PVR induced recurrence of retinal detachment. Interestingly, in the vitreous of eyes with vitreomacular traction, no cells could be detected.

Conclusion

Vitreous changes observed in patients with retinal detachment appear to involve vitreous cells particularly hyalocytes and macrophages, whereas in vitreomacular traction, syndromes no cellular reaction could be detected.

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