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      Premacular Cell Proliferation Profiles in Tangential Traction Vitreo-Maculopathies Suggest a Key Role for Hyalocytes

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          Purpose: To compare immunocytochemical and ultrastructural features of premacular tissue surgically removed from eyes with tangential traction vitreo-maculopathies. Methods: By spectral-domain optical coherence tomography (SD-OCT), premacular tissue was differentiated into premacular proliferation and premacular membrane (PMM). Specimens were harvested during vitrectomy from 10 eyes with macular pucker, lamellar macular hole (LMH) and full-thickness macular hole, and prepared for immunocytochemistry and transmission electron microscopy. Results: All specimens showed positive autofluorescence consistent with the yellow colour of peeled tissue. Glial cells were predominantly positive in premacular proliferation. Hyalocytes were the main cell type in PMM. Electron microscopy revealed densely packed premacular glial cells neighbouring hyalocytes and vitreous collagen strands. Myofibroblasts with features indicative of contractile properties were found in PMM, exclusively. Cell composition of premacular proliferation was free of contractile elements. Conclusion: All three types of vitreo-maculopathy have similar cell constituents in their premacular tissue. Cell population of premacular proliferation is not unique for LMHs. Corresponding to SD-OCT, electron microscopy demonstrates hyalocytes and vitreous collagen in PMMs both directly adjacent to the cellular complex of premacular proliferation. Study results point to the vitreous as one important pathogenic player potentially driving the degenerative cellular process at the vitreoretinal interface in tangential traction vitreo-maculopathies.

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          Most cited references 23

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          The macular pigment. II. Spatial distribution in primate retinas.

          The spatial density distribution of macular pigment in primate retinas was described by two-wavelength microdensitometry of retinal sections. The macular pigment is most dense along the path of the receptor axons in the center of the fovea. Another band of high density is present in the inner plexiform layer in many retinas. The density in both fiber layers declines to low, relatively constant levels within 1 mm eccentricity. Both the total retinal density of macular pigment and the contributions of subsets of the retinal layers were estimated by integrating along the path of light traversing the retina from the vitreal surface to the outer segments. The integrated densities were measured at several eccentricities to establish the profile of macular pigment density along a diameter through the fovea. The macular pigment profile was unimodal in some cases and trimodal in others. The main central peak always occurred in the center of the fovea. The total retinal density of the central peak ranged from 0.42-1.0 absorbance. Most of the pigment is interposed between the outer segments and the stimulating light and is effective as a visual filter. The macular pigment is dichroic, with the major axis of absorption oriented tangential to a circle centered on the fovea. This is consistent with commonly accepted explanations of Haidinger 's brushes.
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            Stereochemistry of the human macular carotenoids.

            To complete identification of the major components of the human macular pigment. Chemical ionization mass spectra of the macular pigment components were obtained and compared with those of zeaxanthin and lutein standards. A comparison was also made using chiral column high-performance liquid chromatography, which is capable of resolving individual stereoisomers of these carotenoids. Zeaxanthin and lutein from human blood plasma were similarly analyzed. The mass spectrometry data supported earlier work in which high-performance liquid chromatography, UV-visible spectrometry and chemical modification showed that the macular pigment comprises two carotenoids with identical properties to those of zeaxanthin and lutein. Chiral column chromatography showed that the "zeaxanthin" fraction is a mixture of two stereoisomers, zeaxanthin itself [(3R,3'R)-beta,beta-Carotene-3,3'-diol] and meso-zeaxanthin [(3R,3'S)-beta,beta-Carotene-3,3'-diol]. The other fraction is the single stereoisomer, lutein [(3R,3'R,6'R)-beta,epsilon-Carotene-3,3'-diol]. In human blood plasma, only zeaxanthin and lutein were found. The results strongly suggest that meso-zeaxanthin results from chemical processes within the retina. Noting that lutein exceeds zeaxanthin in plasma but that the combined zeaxanthin stereoisomers exceed lutein in the retina, the possibility was considered that meso-zeaxanthin is a conversion product derived from retinal lutein. Under nonphysiologic conditions, the authors demonstrate that a base-catalyzed conversion of lutein to zeaxanthin yields only the meso-(3R,3'S) stereoisomer.
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              The macular pigment. I. Absorbance spectra, localization, and discrimination from other yellow pigments in primate retinas.

              The nonbleaching yellow pigments of the primate fovea were studied by microspectrophotometry (MSP). Retinas fixed with glutaraldehyde/paraformaldehyde mixtures retained yellow pigments with absorbance spectra very similar to those recorded by MSP in fresh retinas. This allowed the authors to prepare retinal sections for localization of the pigments. The spectrum of the macular pigment in fixed tissue is shifted slightly (about 6 nm) toward longer wavelengths, with maximum absorbance at 460 nm. Two short-wavelength yellow pigments also have been identified, with absorbance maxima at 410 nm ( P410 ) and 435 nm ( P435 ), respectively. All three yellow pigments are present in the fovea. The short-wavelength pigments are detected more easily outside the central foveal region because the macular pigment does not obscure them there. They are especially apparent when the MSP beam is confined to the outer nuclear layer or the inner segment layer of retinal sections. The macular pigment is most dense in the fiber layers (receptor axon layer and inner plexiform layer); its density declines markedly with retinal eccentricity. The maximal absorbance of P410 and P435 is usually lower than that of the macular pigment in the central fovea, but their densities and relative proportions change more gradually with eccentricity. Consequently, their maximal absorbance is higher than that of the macular pigment outside the foveal center. The P410 and P435 pigments may be two different oxidation states of one or more respiratory hemoproteins. Commonly used procedures for estimating the absorbance spectrum of the macular pigment by comparing the foveal center with a parafoveal region may be influenced by the amounts and the oxidation states of the short-wavelength pigments in the living eye.

                Author and article information

                S. Karger AG
                July 2019
                04 April 2019
                : 242
                : 2
                : 106-112
                Department of Ophthalmology, Ludwig Maximilian University, Munich, Germany
                Author notes
                *Denise Vogt, MD, Department of Ophthalmology, Ludwig Maximilian University, Vitreoretinal Pathology Unit, Mathildenstrasse 8, DE–80336 Munich (Germany), E-Mail denise.vogt@med.uni-muenchen.de
                495853 Ophthalmologica 2019;242:106–112
                © 2019 S. Karger AG, Basel

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                Page count
                Figures: 4, Tables: 1, Pages: 7
                Research Article


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