Subretinal glial membranes in eyes with geographic atrophy

Malia M. Edwards, D. Scott McLeod, Imran A. Bhutto, Rhonda Grebe, Maeve Duffy, Gerard A. Lutty

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


PURPOSE. Müller cells create the external limiting membrane (ELM) by forming junctions with photoreceptor cells. This study evaluated the relationship between focal photoreceptors and RPE loss in geographic atrophy (GA) and Müller cell extension into the subretinal space. METHODS. Human donor eyes with no retinal disease or geographic atrophy (GA) were fixed and the eye cups imaged. The retinal posterior pole was stained for glial fibrillary acidic protein (GFAP; astrocytes and activated Müller cells) and vimentin (Müller cells) while the submacular choroids were labeled with Ulex Europaeus Agglutinin lectin (blood vessels). Choroids and retinas were imaged using a Zeiss 710 confocal microscope. Additional eyes were cryopreserved or processed for transmission electron microscopy (TEM) to better visualize the Müller cells. RESULTS. Vimentin staining of aged control retinas (n ¼ 4) revealed a panretinal cobblestonelike ELM. While this pattern was also observed in the GA retinas (n ¼ 7), each also had a distinct area in which vimentin+ and vimentin+/GFAP+ processes created a subretinal membrane. Subretinal glial membranes closely matched areas of RPE atrophy in the gross photos. Choroidal vascular loss was also evident in these atrophic areas. Smaller glial projections were noted, which correlated with drusen in gross photos. The presence of glia in the subretinal space was confirmed by TEM and cross cross-section immunohistochemistry. CONCLUSIONS. In eyes with GA, subretinal Müller cell membranes present in areas of RPE atrophy may be a Müller cell attempt to replace the ELM. These membranes could interfere with treatments such as stem cell therapy.

Original languageEnglish (US)
Pages (from-to)1352-1367
Number of pages16
JournalInvestigative Ophthalmology and Visual Science
Issue number3
StatePublished - Mar 2017


  • AMD
  • Geographic atrophy
  • Glia
  • Müller cells

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


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