MORPHOLOGIC STUDIES OF THE PERIPHERAL VITREORETINAL INTERFACE IN HUMANS REVEAL STRUCTURES IMPLICATED IN THE PATHOGENESIS OF RETINAL TEARS

Purpose: The ultrastructural nature of the preequatorial vitreoretinal interface was studied to elucidate the predisposing role for peripher al retinal tear formation. Methods: Fourteen enucleated globes from se ven deceased patients were examined. The patients ranged in age from 1 6-88 years, with an average age of <(40)under bar> years. None of the patients had a history of ocular or systemic disease that could have a ffected the eyes. Globes were examined by stereomicroscopy and by ligh t and electron microscopy using the celloidin embedding method. Result s: On examination we found several structures in addition to tufts and rosettes. In the vitreous cortex, fibrillar structures with no vitreo retinal attachment to the retina frequently were found. We propose tha t these structures be called ''tubuli'' because of their spiral appear ance. Mushroom-like structures, which we propose be referred to as ''s piculae,'' were found to arise from the intact internal limiting lamin a of the retina and to insert into the vitreous cortex, constituting f oci of vitreoretinal adhesion. Other structures, which we propose be c alled ''verrucae,'' arose from the disrupted internal limiting lamina of the retina and inserted into disrupted areas of vitreous cortex. Co nclusions: Tubuli appear to be remnants of the embryonic vasculature w ith no clinical or pathologic significance. Because of their pattern o f inserting into the internal limiting lamina of the retina and the pe ripheral vitreous cortex, spiculae and verrucae may play an important role in the formation of retinal breaks.