J Korean Ophthalmol Soc.  2017 Nov;58(11):1307-1312. 10.3341/jkos.2017.58.11.1307.

Hyper-proliferation of Glial Tissues Following Autologous Internal Limiting Membrane Transplantation in Idiopathic Large Macular Holes

• Park JH
• Jung JW
• Lee SM
• Park SW
• Lee JE
• Byon IS

• KMID: 2395875
• DOI: http://doi.org/10.3341/jkos.2017.58.11.1307

Abstract

PURPOSE
To report three cases of glial hyper-proliferation after autologous internal limiting membrane (ILM) transplantation in idiopathic large macular holes.
CASE SUMMARY
Three eyes with full thickness macular holes >500 µm underwent autologous ILM transplantation. After surgery, the macular hole was closed and foveal contour was U-shaped. Optical coherence tomography revealed long-lasting proliferation of glial cells in the fovea after the hole closure. This glial proliferation continued for 6 months, with improved visual acuity, and bump-like features of the fovea.
CONCLUSIONS
Autologous transplantation of ILM effectively induced long-lasting proliferation of glial cells, thereby achieving the closure of large macular holes. However, an abnormality of the foveal contour may develop after the hole closure in some cases.

Keyword

Autologous internal limiting membrane transplantation; Glial cell; Hyper-proliferation; Macular hole

MeSH Terms

Autografts
Membranes*
Neuroglia
Retinal Perforations*
Tomography, Optical Coherence
Transplantation, Autologous
Visual Acuity

Figure

• 

  Figure 1 A Case of 67-year-old woman with full thickness macular hole. Two weeks after autologous internal limiting membrane transplantation, optical coherence tomography images showed a glial tissues in the fovea without a complete hole closure. The long-lasting proliferation of glial cells (yellow arrows) resulted in the closure of hole, but the abnormal contour of fovea was postoperatively observed from 3 months to 24 months. The defects of ellipsoid zone (black arrowheads) and external limiting membrane (white arrowheads) remained. The foveal depigmentation was seen in the postoperative fundus photographs.

• 

  Figure 2 A case of 70-year-old woman with full thickness macular hole. One month after autologous internal limiting membrane transplantation, the closure of the hole and glial tissues in fovea (yellow arrow) were observed in optical coherence tomography. Foveal depigmentation was seen in fundus photography. At 6 months, the protrusion of fovea developed. The defects of ellipsoid zone (black arrowheads) and external limiting membrane (white arrowheads) remained.

• 

  Figure 3 A case of 75-year-old woman with full thickness macular hole. One month after autologous internal limiting membrane transplantation, irregular contour of fovea (yellow arrows) was detected in optical coherence tomography. At 3 months, the bump-like fovea developed. The depigmentation of fovea was seen in postoperative fundus photograph. The defects of ellipsoid zone (black arrowheads) and external limiting membrane (white arrowheads) remained. And it lasted until 6 months.

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