Separation of the vitreous and posterior hyaloid membrane (PHM) or posterior vitreous detachment (PVD) typically occurs between the ages of 45 and 65 years in the general population, but may occur earlier in myopic or otherwise predisposed individuals. Age-related synergetic changes occurring within the cortical and central gel must be distinguished from the PHM, which envelopes it. This study reports on the correlation between 'true' PVD seen clinically by the physician using dynamic examination, high-power slit-lamp biomicroscopy, and oblique illumination with some of its histological, immunohistochemical, and ultrastructural features post-mortem. The presence of the Weiss ring does not necessarily indicate total clean separation of PHM, nor does its absence confirm that the PHM remains attached, since it may be destroyed during the process of separation. Immediately prior to PVD with the vitreous gel attached, the PHM must, by definition, form part of the inner limiting membrane. The detached PHM frequently exhibits basement membrane (BM) and its indigenous laminocytes stain focally for GFAP and type IV collagen. The PHM is distinct from and much thicker than the BM of Müller cells alone and the factors that initiate or limit separation of the PHM require greater study, particularly the role of laminocyte proliferation and migration.

译文

在一般人群中,玻璃体和后玻璃体膜 (PHM) 或玻璃体后脱离 (PVD) 的分离通常发生在45至65岁之间,但在近视或其他易患个体中可能更早发生。皮质和中央凝胶内发生的与年龄有关的协同变化必须与包裹它的PHM区分开。这项研究报告了医师使用动态检查,大功率裂隙灯生物显微镜和斜视照明及其某些组织学,免疫组织化学和死后超微结构特征在临床上所见的 “真实” PVD之间的相关性。Weiss环的存在不一定表示PHM的完全干净分离,也不一定表明PHM的缺失仍然存在,因为它可能在分离过程中被破坏。在附着玻璃体凝胶的PVD之前,根据定义,PHM必须形成内部限制膜的一部分。分离的PHM经常表现出基底膜 (BM),其本地层细胞染色局部为GFAP和IV型胶原蛋白。PHM与单独的m ü ller细胞的BM不同且厚得多,启动或限制PHM分离的因素需要更多的研究,尤其是层细胞增殖和迁移的作用。

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