视网膜内界膜的结构和生理功能及其在相关疾病中的作用  

Structure and physiological function of internal limiting membrane and its role in related diseases

作　　者：梁佳(综述) 陈璐[1] 张少冲(审校) Liang Jia;Chen Lu;Zhang Shaochong(Retina Department,Shenzhen Eye Hospital,Jinan University,Shenzhen Eye Institute,Shenzhen 518040,China)

机构地区：[1]深圳市眼科医院眼底病科,暨南大学附属深圳眼科医院,深圳市眼病防治研究所,深圳518040

出　　处：《中华实验眼科杂志》2024年第5期478-482,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金(82301223、82271102);广东省基础和应用基础研究基金(2022A1515111155);深圳市科技计划项目(KCXFZ20211020163813019、RCB20210706092347043)。

摘　　要：内界膜是Müller细胞基底膜、少量胶质细胞组成的半透明均质膜。内界膜组分中的α胶原蛋白、硫酸盐蛋白糖、层粘连蛋白等在视网膜基底膜和视网膜神经血管的发育以及视网膜屏障的形成中发挥着重要作用,其成分结构以及理化性质的病理改变与许多玻璃体视网膜疾病的发生发展息息相关。目前,内界膜剥除术可有效解除残留玻璃体皮质对视网膜的牵拉,预防术后黄斑前膜的生成,被广泛用于内界膜相关疾病,但仍存在视网膜微结构和生理功能受损等问题。因此,多种内界膜改良术也应运而生,包括保留中心凹的内界膜剥除、内界膜翻转、自体内界膜移植等。本文就内界膜的理化性质、生理功能、相关疾病中的病理改变及内界膜相关的手术方式进行综述,旨在加深对内界膜的认识,为临床相关疾病的诊疗提供帮助。Internal limiting membrane(ILM)is a translucent homogeneous membrane composed of Müller cell basement membrane and a small number of glial cells.The alpha collagen,sulfate protein sugar and laminin in ILM play important roles in the development of retinal basement membrane and neurovascular structure and in the formation of retinal barrier.However,when pathological changes occur in its composition,structure and physical and chemical properties,it may cause the occurrence and development of many vitreoretinal diseases.At present,ILM peeling which is widely used in vitreoretinal diseases can effectively relieve the traction of residual vitreous cortex on retina and prevent postoperative epiretinal membrane formation,but there are still some problems such as retinal microstructure and physiological function damage.Therefore,some ILM-modified surgeries have been developed,including fovea-sparing ILM peeling,inverted ILM flap,and ILM transplantation technique.This article summarizes the physical and chemical properties,physiological functions,pathologic changes in ILM-related diseases and ILM-related surgical methods,with the goal of providing an advanced understanding of the ILM and aiding in clinical diagnosis and treatment.

关 键 词：内界膜 理化性质 生理功能 病理改变 手术方式 

分 类 号：R774.1[医药卫生—眼科]