[Asteroid hyalopathy. Ultrastructural study of 3 cases]

Abstract

The vitreous of three patients with asteroïd hyalosis (average age: 57 years) was obtained by a two-hand closed pars plana vitrectomy. Asteroïd hyalosis was associated with alcoholic neuropathy in the first case, long standing retinal detachment in the second case, and diabetes mellitus in the third case. The visual acuity before and after the surgical procedure improved from 1.2/6 to 6/6 in the first case, from light perception to 0.3/6 in the second case, from 0.6/6 to 4.8/6 in the third case. The vitreous was studied by different ultrastructural technics : transmission electron microscopy (T.E.M.) scanning electron microscopy (S.E.M.) and electron diffraction X ray analysis (E.D.A.X.). By S.E.M. the asteroïd bodies appeared as rounded structures with an irregular surface connected to each other by fibrous strands among sodium chloride crystals. No cellular remnants were observed. By T.E.M. the asteroïd bodies were composed of interwinned ribbons of multilaminar membranes with a periodicity (10 to 60 A) characteristic of complex lipids, especially phospholipids. At the edge of the ribbons there were dots and sometimes clumps of opaque material that tended to crack out of the specimen with the heat of the electron beam. T.E.M. study disclosed the irregular disposition of the calcific bodies. By E.D.A.X. the calcific composition of the rounded structures could be determined : calcium and phosphorus were the main elements detectable in asteroïd bodies of all sizes for all three patients. The average calcium counts for the three successive cases were : 18, 30, 43 and for phosphorus : 9, 14, 26. Potassium was found in the first case, and sulfur in the third case.(ABSTRACT TRUNCATED AT 250 WORDS)