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Epiretinal Membrane

The retina is a tissue that lines the almost the entire inside of the eye. It is a very specialized tissue that collects light information and transmits it to the brain providing us with vision. The macula is a small portion of the retina at the back of the eye that is responsible for central vision and gives us our fine detailed vision and color perception. The posterior segment of the eye (inside of the eye, behind the lens) is filled with a gelatinous substance called vitreous. When we are young, the vitreous is a consistent gel and is adherent to the retina. Over time as we age, parts of the vitreous gel become liquefied and other parts clump together (perceived as floaters). Also as a part of normal aging, the vitreous will release itself from the retina (posterior vitreous detachment - PVD). As this process evolves, the vitreous can remain adherent over the macula causing a reactive membrane to form over this area - this is called and epiretinal membrane (ERM). 'Cellophane maculopathy' is another term that has been used to describe this condition. ERM can also form in reaction to inflammation in the eye, trauma, diabetes, and vein occlusion in the eye. The epiretinal membrane can contract causing significant retinal distortion and has been called 'macular pucker' when this occurs.

ERM can cause a varying degree of central vision blurring and distortion. The ERM does not resolve on its own, but some remain mild with minimal effects on vision. If vision is only mildly affected, then it is best to be conservative without active treatment. The ERM can gradually progress and become thicker, cause retinal traction, swelling and distortion and this can cause a gradually progressive impairment of central vision. If this occurs, vitrectomy surgery can be helpful.

Vitrectomy surgery is a day surgery procedure done under local anesthetic. Please refer to the page on Vitrectomy surgery for further details. With this surgery, after the vitreous gel is removed, the epiretinal membrane is directly grasped and peeled off of the retina. Vision is typically worse immediately after surgery and recovers to its pre-surgery level over about 2-3 weeks after which continued slow improvement occurs for several months. Typically, vision improves significantly over time, but does not recover completely to normal – some mild central blur and distortion can persist.

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