Correlation of collagen fibril properties and inner limiting membrane thickness with vitreoretinal adhesion in human eyes.

Vitreoretinal adhesive strength is thought to play a mechanical role in various retinal diseases; however, collagen fibril properties and inner limiting membrane (ILM) thickness have not been quantitatively correlated to adhesive strength. In this work, we quantified the relationship between collagen fibril density, angle, length, and ILM thickness with vitreoretinal adhesive strength to advance our understanding of structure-function relationships in vitreoretinal adhesion. Following mechanical peel tests, human retinal sections from the equator and posterior pole of donors 42-89 years of age were extracted and processed for transmission electron microscopy. Collagen fibrils at the vitreoretinal interface were segmented and fibril density, angle, length, and ILM thickness quantified. Morphological measurements were correlated with vitreoretinal adhesion measured in the same location. We found that collagen fibril density was 1.6 times greater in the equator compared to the posterior pole across all ages (p=0.0305). Steady-state peel force showed a slight positive correlation with increasing density in both the equator and posterior pole, but was only statistically significant in the equator (p<0.05). Collagen fibril angle and length did not significantly vary with age or region. ILM thickness was 3.8 times thicker in the posterior pole compared to the equator (p<0.0001). ILM thickness was 1.8 times greater in eyes ≤60 years of age compared to eyes >60 of age (p=0.0136). Maximum peel force was significantly correlated with increasing ILM thickness in the equator (p=0.015). A similar trend was seen in the posterior pole, but this was not significant. These data suggest that collagen contributes to adhesion at the vitreoretinal interface, but the structure of the ILM is more influential on the initiation of separation between the vitreous and retina.