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A Review of Vitreoretinal Interface Pathology

The vitreoretinal interface has been identified as the site of many different forms of retinal pathology. The dynamic interaction between the vitreous and the retina has implications for pathology both peripherally and in the posterior pole, in particular, the macula. Before the development of optical coherence tomography (OCT), clinicians relied on astute clinical observation and fundoscopy, fluorescein angiography (FA), and postmortem histology to make assumptions about the role the vitreoretinal interface plays in macular pathology. OCT has given us the ability to view the macula in cross section with resolutions of 1 to 15m and thus has improved our understanding of the following known clinical entities: posterior vitreous detachment (PVD), vitreomacular traction (VMT) syndromes, macular holes, and epiretinal membranes (ERMs). The diagnosis and treatment of these visually indistinct pathologic entities has continued to be a challenge and debated in the literature. A clear understanding of the histopathology of the vitreoretinal interface is useful when treating macular disease. This paper attempts to review the current literature focusing on the histology and ultrastructural pathology of the vitreoretinal interface.