An epiretinal membrane (ERM) has other names such as macular pucker or cellophane maculopathy. It is often referred to as a “wrinkle on the retina.”
Epiretinal membranes are quite common and occur in perfectly normal eyes.
Symptoms of Macular Pucker
An ERM is a thin membrane which covers the surface of the macula. The macula is the functional center of the retina providing 20/20 acuity and our best ability to see colors.
The membrane can cause the underlying macular tissue to wrinkle or “pucker” causing blurry vision and/or distortion.
Many ERMs do not affect vision and may be monitored.
What Causes an ERM?
In many cases, an epiretinal membrane can form on the surface of the retina following a PVD (posterior vitreous detachment), cataract surgery or following a retinal detachment or retinal tear.
Diagnosis of ERM
As with most retinal diseases, a dilated eye exam must be performed.
After direct examination, Drs. Friedman and Moinfar will often confirm the diagnosis of macular pucker with specialized testing to include an Optical Coherence Tomography, fundus photography or fluorescein angiography.
Surgery
The goal of treatment is to surgically remove the epiretinal tissue.
Microsurgical instruments and an operating microscope in combination with sutureless vitrectomy techniques can be used to delicately peel the membrane from the retinal surface. After removing the vitreous, the membrane can stained using special dyes allowing us to better visualize the membrane. We have found that use of the dyes allows easier visualization, but also decreases recurrence.
Surgery is performed as an outpatient. Most cases are performed while you are are awake, but very comfortable. The procedure is painless.
Surgery is generally recommended for patients with progressive loss of vision and worsening distortion. Progression can be correlated to worsening vision and/or changes in the examination such as the OCT.
On very rare occasion, the ERM can spontaneously separate from the retina.
