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An epiretinal membrane is
a proliferation of abnormal tissue on the surface of the retina.
The abnormal tissue tends to accumulate in the center of the retina
in an area called the macula. The macula contains the highest concentration
of cells responsible for the reception of light stimuli from our
environment. It is the macula that is responsible for the central
portion of our vision. Common synonyms for epiretinal membrane include
macular pucker, premacular fibrosis, cellophane maculopathy, surface
wrinkling retinopathy and epimacular membrane.
The majority of patients
who get epiretinal membranes are over the age of 50 years old. Occasionally,
children and young adults may get an epiretinal membrane. The prevalence
of epiretinal membrane in patients over the age of 50 is probably
about 6%.
There are several causes
of epiretinal membrane. They may occur after intraocular surgery,
particularly after retinal detachment. Any type of intraocular inflammation
can cause epiretinal membrane. Holes or tears in the retina and
ocular trauma or injury can incite membrane formation. Some membranes
are idiopathic meaning that there is no obvious cause.
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Photos of Epiretinal Membrane
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The most common symptom of
epiretinal membrane is visual distortion. Objects may look irregular
or bent. As the membrane progresses, the retina becomes thickened.
This is referred to as retinal or macular edema. A special test
called optical coherence tomography is very accurate at detecting
macular edema.
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Normal
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Abnormal
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Optical Coherence Tomogram centered
under the two images. |
The only treatment for epiretinal
membrane is surgery. Medications such as nonsteroidal antiinflammatory
agents may decrease the macular edema but will not cure the membrane.
The majority of membranes remain relatively asymptomatic for long
Periods of time. The mere presence of a membrane is not an indication
for surgery. When patients are sufficiently bothered by the decrease
in vision or the distortion caused by the membrane, a vitrectomy
may be indicated.
A vitrectomy is a surgical
procedure where the vitreous gel inside the eye is removed and replaced
with either a salt solution or gas. The membrane can then be peeled
away from the surface of the retina. The majority of patients obtain
good vision after this type of surgery. Some of the possible complications
of vitrectomy surgery are cataract formation, retinal detachment,
and infection.
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Optical Coherence Tomogram
after surgical treatment
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Vitreoretinal
Disease Features
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