We wish to thank Dr Gass for his interest in our recent article.1 As outlined in the report and its accompanying figures, neuronal perikarya (somata) were present in all 7 specimens that contained neuroretinal tissue in addition to neuritic processes, which included synaptic complexes identifiable as cone pedicles typically found in the outer plexiform layer of the retina. The presence of these neural cell bodies indicates that opercula that contain neuroretinal tissue were, therefore, not merely avulsed inner lamellar retina that contained fragments of superficial photoreceptor and ganglion cell neuritic processes. Furthermore, most of the neural somata measured in the region of 5 µm, which is consistent with cone somata indicating a full-thickness tear.
Ezra E, Munro PMG, Charteris DG, Aylward WG, Luthert PJ, Gregor ZJ. Macular Hole Opercula: Ultrastructural Features and Clinicopathologic Correlation—Reply. Arch Ophthalmol. 1998;116(7):965-966. doi: