![]() ![]() The mechanism by which interdigitations of RPE apical villous processes and photoreceptor outer segments contribute to retinal adhesion is not yet clear. 16, 17, 18 Factors that affect the physicochemical properties of the IPM and enzymes that degrade some of its components weaken retinal adhesion. 13, 14, 15, 16 Cell adhesion molecules or receptors may be involved in this interaction between the matrix and the cellular membranes. The IPM also has structural components that remain attached to both the RPE and the cones if the NSR was peeled off the RPE. 11 This matrix may act as a glue 12 binding the NSR and RPE. It is predominantly composed of glycosaminoglycans. Mechanical forces inside the SRS include the matrix material between the NSR and RPE and the interdigitations between the RPE microvilli and the photoreceptors.Ī matrix is present in-between photoreceptor outer segments and is called the interphotoreceptor matrix (IPM). 9 Whether the vitreous plays a direct role in retinal adhesion is yet to be determined although some studies suggest that the physical structure of the vitreous might be of importance in maintaining retinal apposition. 7, 8įormed vitreous acts as a seal to retinal breaks and indirectly aids in preventing retinal detachment and maintaining adhesion between the retina and RPE. This inward vector of fluid movement could lead to retinal separation from the RPE because of retinal resistance to flow. 5, 6 Likewise, a drug that increases the vitreous oncotic pressure tends to withdraw fluid into the vitreous from the choroid through the retina. 3, 4 Because the retina and RPE substantially resist fluid transport, the outward vector of fluid movement tends to push the retina against the RPE. Fluid exits the eye through the trabecular meshwork however, a small proportion tends to exit from the vitreous to the choroid by virtue of the intraocular and choroidal oncotic pressures. ![]() Mechanical forces outside the SRS include fluid pressures and vitreous. 2 Mechanical factors in turn are divided into those outside and those inside the subretinal space (SRS). The forces of adhesion between the two layers can be divided into mechanical and metabolic.
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