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<b><i>Purpose:</i></b> To compare immunocytochemical and ultrastructural features of premacular tissue surgically removed from eyes with tangential traction vitreo-maculopathies. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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. <b><i>Conclusion:</i></b> 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.

This study demonstrates abundance of fibroblasts, myofibroblasts, and glial cells in PMM from idiopathic macular pucker following tissue culture with tangential stretch application. We found enhanced contractive properties of the cultured PPM that appear to indicate transdifferentiation of the cell composition. This in vitro model may improve understanding of pathogenesis in traction maculopathies and help to establish further anti-fibrosis treatment strategies.