Epiretinal membranes (ERM) are an abnormal growth of translucent cells on the surface of the retina. This tissue growth tends to acculumate in the macula, which is the center of the retina. The macula is responsible for the central portion of our vision.
Epiretinal membrane may also be called macular pucker, premacular fibrosis,cellophane maculopathy, surface wrinkling retinopathy and epimacular membrane.
The majority of patients who get epiretinal membranes are over 50 years old. About 6% of people over 50 may develop this condition. Children and young adults may occasionally get an epiretinal membrane, but this is far less common.
What causes Epiretinal membrane?
- Posterior vitreous detachment (PVD) –the vitreous gel that fills the eye separates from the retina
- Complication from a retinal detachment or other eye surgery
- Inflammation in the eye
- Holes or tears in the retina
- Eye trauma or injury
Most patients with ERMs have no symptoms, and their vision may be close to normal. Their eye care provider may find the problem during a routine eye exam or with an imaging exam called OCT (optical coherence tomography).
Some ERMs progress and cause vision problems. The most common symptom is visual distortion. Normally straight shapes (such as a door frame) may look irregular or bent. As the membrane grows, the retina becomes thickened. This is called retinal or macular edema (swelling), and can be seen on an OCT.
The only treatment for epiretinal membrane is surgery. Some anti-inflammatory medications may decrease the macular edema, but will not cure the membrane. The majority of membranes do not cause symptoms for long periods of time, and do not require surgery. When patients notice a significant decrease or distortion in vision, a surgical procedure called vitrectomy may be indicated.
In a vitrectomy the vitreous gel inside the eye is removed and replaced with either a salt solution or gas. The surgeon can then peel the membrane away from the surface of the retina. The majority of patients achieve good vision after this surgery.
Complications of Surgery
Some possible complications of vitrectomy surgery are retinal detachment and infection. The risks of complication are small.
Cataracts may develop or progress in the surgical eye following a vitrectomy.
Optical Coherence Tomogram after surgical treatment