Retinal reattachment of the primate macula. Photoreceptor recovery after short-term detachment.

The macula of the neural retina from 12 adult rhesus monkeys (Macaca mulatta) was detached from the overlying retinal pigment epithelium (RPE) by subretinal injection of a balanced salt solution. Seven days later, the two layers were reapposed by draining fluid from the vitreous cavity and replacing it with a 3:1 mixture of sulphur hexafluride gas and air. Animals were sacrificed at 1 hr, 2 days and 7 days after detachment, and at periods ranging from 3 to 14 days after reattachment. At 2-7 days prior to sacrifice, some eyes received an intravitreal injection of 3H-L-fucose. The eyes were then fixed for light and electron microscopy (EM), and tissue sections were processed for autoradiography (ARG) or immunocytochemistry. During the 7-day detachment interval, rod outer segments (ROSs) and cone outer segments (COSs) degenerated, but inner segments remained intact and the rest of the retina appeared normal. The apical RPE surface dedifferentiated during the detachment interval. At 3 days after reattachment, a regrowth of rudimentary ROSs and COSs had occurred, but the disc stacking was clearly abnormal. ROSs and COSs both showed an increase in length and a tendency to return to their normal configurations with increasing time after reattachment. ROSs and COSs regained approximately 40% of their normal lengths after a 2-week reattachment period; however, persistent outer segment abnormalities were frequently found in otherwise well regenerated areas. Autoradiographic results confirmed that new disc members were synthesized subsequent to reattachment. Newly synthesized rod disc membranes were uniformly labeled using antibodies to bovine opsin. Regenerating outer segments interdigitated with newly formed apical RPE processes, and radiolabeled phagosomes were identified within the RPE cytoplasm by 1 week after reattachment. Proliferation of the RPE cell layer was identified at some locations in all animals, and was strongly correlated with a lack of underlying outer segment regeneration. Because of the short detachment interval, and the absence of underlying pathology or trauma, the recovery process described here probably represents an example of optimum recovery after retinal reattachment.