Hemorrhagic detachment of the internal limiting membrane after penetrating ocular injury

Abstract

During surgery to remove an intraocular gunshot pellet, a loculated "preretinal" hemorrhage was identified. This provided an opportunity to evaluate the structural identity of the inner wall, presumably representing detached posterior vitreous. The preretinal membrane was excised and evaluated using lectin histochemical analysis. All lectins tested bound to the excised tissue, supporting the conclusion that the membrane was a hemorrhagic internal limiting membrane detachment resulting from direct penetrating ocular injury. During intraoperative biomicroscopic examination, this detachment was indistinguishable from a subhyaloid hemorrhage. Because there are no natural history studies on internal limiting membrane loss and damage to retinal visual function, caution is urged in the surgical management of these lesions.