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Klin Monbl Augenheilkd 2015; 232(4): 500-505
DOI: 10.1055/s-0035-1545778
Klinische Studie
Georg Thieme Verlag KG Stuttgart · New York

Tendinous Muscle Insertions (Scleromuscular Junctions of the Recti Muscles) in Patients with Ocular Alignment Problems

Sehnen/Muskel-Ansatzstellen (skleromuskuläre Verbindung der geraden Augenmuskeln) bei schielenden Patienten
M. G. Todorova
1   Department of Ophthalmology, University of Basel, Basel, Switzerland (Chairman a. i.: Dr. sc. nat. Norbert Spirig)
,
A. M. Palmowski-Wolfe
1   Department of Ophthalmology, University of Basel, Basel, Switzerland (Chairman a. i.: Dr. sc. nat. Norbert Spirig)
,
P. Meyer
1   Department of Ophthalmology, University of Basel, Basel, Switzerland (Chairman a. i.: Dr. sc. nat. Norbert Spirig)
2   Department of Pathology, University of Basel, Basel, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
22 April 2015 (online)

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Abstract

Background: The purpose of this study was to prove the hypothesis whether the scleromuscular junction of extraocular recti muscle is tendinous.

Patients and Methods: Muscle samples of the 41 extraocular recti muscles of 33 patients and 4 muscle-/eye-matched samples from 2 postmortem eyes, were processed for light/electron microscopy and immunohistochemistry with antibodies against desmin, smooth-muscle actin and muscle regulating proteins like myf3 and myf4 (myogenin), tenascin C and for 8 samples against collagens I to IV.

Results: Histological examination of the muscle samples confirmed a thick collagen-structured tissue, specific for muscle tendon; without appearance of muscle tissue. This was confirmed by immunohistochemistry with antibodies against desmin, smooth-muscle actin, myf3 and myf4 (myogenin) and for eight samples with collagens I to IV. Anti-tenascin C marker was only strongly positive in the connective tissue of the blood vessel walls. Electron microscopy demonstrated collagen bundles composed of parallel oriented fibrils with a moderate amount of ground substance.

Conclusions: The absence of contractile fibers at the sclerotendinous junction is an entirely normal finding in humans and cannot be related to ocular alignment pathogenesis.

Zusammenfassung

Hintergrund: Ziel der Studie ist es zu evaluieren, ob Muskelfasern bei der Ansatzstelle der geraden Augenmuskels vorkommen.

Patienten und Methoden: Muskelexzisate von 41 geraden Augenmuskels von 33 Patienten nach Resektion bei Stellungsfehler wurden untersucht und mit 4 geraden Augenmuskel-Postmortem-Exzisate bei 2 Probanden verglichen. Es erfolgte eine lichtmikrokopische, elektronenmikroskopie und immunochistochemische Beurteilung der Präparate mittels Antikörpern auf Desmin, Smooth-Muscle-Actin sowie auf muskelregulierende Proteine wie myf3 und myf4 (Myogenin), Tenascin C und für 8 Exisate auf Kollagen I bis IV.

Ergebnisse: Alle Präparate zeigten histologisch strangförmiges, leicht vaskularisiertes, dichtes kollagenes Bindegewebe ohne Vorkommen von quergestreiften Muskelfasern. Die fehlenden Muskelfasern im Bereich der Sehnen-Sklera-Ansatzstellen wurden mittels immunhistochemischer Untersuchung (Desmin, Smooth-Muscle-Actin, myf3 und myf4 neg) bestätigt. Tenascin C konnte nur im kollagenen Bindegewebe der Gefässe gefunden worden. Elektronenmikroskopisch liessen sich Kollagenfaserbündel mit parallel orientierten Fibrillen und einer moderaten Menge von Grundsubstanz nachweisen.

Schlussfolgerung: Der sehnenartige Aspekt der Muskelansatzstellen an der Sklera mit fehlenden kontraktilen Muskelfaserelementen sind mit der klassisch beschriebenen Anatomie der geraden Augenmuskel beim Menschen vereinbar und können die Pathogenese der Stellungsfehler bei schielenden Patienten nicht erklären.

Schlüsselwörter

gerade Augenmuskel - Sehnen - kollagenes Bindegewebe - schielende Patienten - Immunochistochemie - Lichtmikrokopie - Elektronenmikroskopie

Key words

extraocular recti muscle - tendon - collagen tissue - alignment axis - immunohistochemistry - light microscopy - electron microscopy
 

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