Ultrastructural features of surgically excised subretinal neovascular membranes in the ocular histoplasmosis syndrome
S. J. Saxe, H. E. Grossniklaus, P. F. Lopez, H. M. Lambert, P. Sternberg Jr and N. L'Hernault
Department of Ophthalmology, Emory University, Atlanta GA.
We evaluated the ultrastructural features of seven surgically excised
submacular neovascular membranes from seven patients with the ocular
histoplasmosis syndrome. Excised neovascular membranes were composed of
fibrovascular tissue interposed between Bruch's membrane and the retinal
pigment epithelium. Cellular components present in the membranes included,
in decreasing order of frequency, retinal pigment epithelium, vascular
endothelium, photoreceptor cells, macrophages, erythrocytes, ghost
erythrocytes, fibrocytes, myofibroblasts, glial cells, smooth-muscle cells,
and lymphocytes. Extracellular constituents of the neovascular membranes
included 20 to 25-nm collagen fibrils, fibrin, 10-nm collagen fibrils, and
fragments of Bruch's membrane and choroid. Our findings are consistent with
the concept that subretinal neovascular membranes in the ocular
histoplasmosis syndrome represent a nonspecific healing response to a local
stimulus or injury.
