Biomechanical stress in the retinal pigment epithelium surrounding laser scars in humans

In five human patients with enlarging retinal pigment epithelium laser scars, transscleral illumination adaptive optics ophthalmoscopy shows coordinated mosaic displacement up to several hundred microns from scar edges over 13–60 months.

• Why it matters: Epithelial wound mechanics can sometimes enlarge holes, but the biomechanical basis for long-term laser scar expansion in human RPE is unclear.
• What they did: The authors analyzed time-lapse AOO imaging in three patients and tracked dynamic changes in RPE margins; they also used confocal microscopy on a phalloidin-labeled human donor RPE flat-mount with scatter photocoagulation history to map stress fibers and cell metrics.
• The result: Scar enlargement coincided with long-lasting, large-scale displacement of microscopic features and elongated RPE cells with actin cable stress fibers along scar edges, suggesting epithelial biomechanics may contribute to these movements.

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