Vitreo-macular adhesion/traction and macular holes: Pseudo, lamellar, and full-thickness

Abstract

Vitreous consists of approximately 98 % water and 2 % structural macromolecules [1, 2]. It is attached to all contiguous structures of the inner eye, including the internal limiting membrane (ILM) of the retina. The ILM is primarily composed of type IV collagen. The interface between the ILM and posterior vitreous cortex contains a macromolecular attachment complex, which is composed of fibronectin, laminin, and other extracellular components such as glycoproteins and several collagen types [3–5]. This complex, along with the chondroitin sulfate present throughout the vitreo-retinal interface, plays a major role in vitreo-retinal adhesion [see chapter II.E. Vitreo-retinal interface and ILM]. Chondroitin sulfate may also play a role in mediating hyaluronan-collagen interaction in the gel vitreous [6, 7].