Epiretinal membrane

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Obesity, Sleep & Internal medicine
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Epiretinal membrane
OCT image of an epiretinal membrane
Synonyms	Macular pucker, cellophane maculopathy, surface wrinkling retinopathy
Pronounce	N/A
Specialty	N/A
Symptoms	Visual distortion, blurry vision, double vision
Complications	Retinal detachment, macular hole
Onset	Typically in adults over 50
Duration	Chronic
Types	N/A
Causes	Idiopathic, retinal detachment, diabetic retinopathy, uveitis
Risks	Age, diabetes, eye surgery, eye trauma
Diagnosis	Ophthalmoscopy, optical coherence tomography
Differential diagnosis	Macular degeneration, retinal vein occlusion
Prevention	N/A
Treatment	Vitrectomy, observation
Medication	None specific, anti-VEGF for associated conditions
Prognosis	Variable, often stable, can improve with surgery
Frequency	Common in older adults
Deaths	N/A

Amsler grid used for detecting visual disturbances

Epiretinal Membrane (ERM), also known as macular pucker or cellophane maculopathy, is a condition where a thin, transparent layer of fibrous tissues forms on the inner surface of the retina, particularly over the macula, which is responsible for sharp central vision. This condition can lead to vision distortion and blurring. ERMs are more common in individuals over the age of 50, but they can occur at any age.

Causes and Risk Factors

The exact cause of epiretinal membrane formation is not fully understood. However, it is often associated with changes in the vitreous humor – the gel-like substance filling the eye. As people age, the vitreous may shrink and separate from the retina, a process known as Posterior Vitreous Detachment (PVD). This can lead to the formation of ERMs. Other risk factors include:

• Retinal detachment
• Retinal tear
• Inflammation inside the eye (Uveitis)
• Eye surgeries
• Trauma to the eye

Symptoms

Symptoms of an epiretinal membrane can vary from none to severe, depending on the membrane's thickness and location. Common symptoms include:

• Blurred vision
• Distorted vision (straight lines appear wavy)
• Difficulty reading or performing tasks that require detailed vision
• Double vision in the affected eye

Diagnosis

Diagnosis of an epiretinal membrane is primarily based on a comprehensive eye examination. Key diagnostic tools include:

• Ophthalmoscopy: An examination of the retina's condition through a dilated pupil.
• Optical Coherence Tomography (OCT): A non-invasive imaging test that provides detailed images of the retina, allowing for the visualization of the membrane's presence and thickness.

Treatment

Treatment for an epiretinal membrane may not be necessary if symptoms are mild. Monitoring the condition with regular eye exams may be all that is needed. For more severe cases affecting vision, the surgical removal of the membrane may be recommended. The procedure, known as vitrectomy, involves removing the vitreous gel and peeling away the membrane from the retina. Surgery can improve vision, but it may not restore it to normal, and there are risks involved, including cataract formation and retinal detachment.

Prognosis

The prognosis for individuals with an epiretinal membrane varies. Some people may experience a gradual improvement in their symptoms, while others may notice a progressive worsening. Surgical intervention has a good success rate in improving vision, but as with any surgery, outcomes can vary.

Prevention

There are no specific measures to prevent the formation of an epiretinal membrane. However, maintaining overall eye health through regular eye exams can help in early detection and management of conditions that could potentially lead to ERM.

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