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To the Editor.
—In a recent clinicopathologic study Campochiaro et al1 reported immunocytochemical analysis of tissue obtained at the time of vitrectomy from two patients with "premacular hole lesions." I agree with their conclusion that this tissue is most likely posterior vitreous cortex removed from the premacular region. I furthermore agree with the contention that the cells in this tissue are likely responsible for the contractile forces that act on the macula, inducing striae, pucker, cysts, and in some cases, holes. The suggestion that these cells derive from retinal pigment epithelium and retinal glia is interesting but not conclusive. Although the authors invoke growth factor—stimulated cellular infiltration of the vitreous cortex as a possible mechanism, it is difficult to concur given that the retina is intact in the two cases that they studied. Furthermore, there is another equally plausible, if not more likely, explanation for these findings.Studies2-4
Sebag J. Tissue Analysis From Two Patients With Premacular Hole Lesions. Arch Ophthalmol. 1993;111(1):22. doi:10.1001/archopht.1993.01090010024010