What is an epiretinal membrane?
Epiretinal membrane (also known as macular pucker, cellophane maculopathy, pre-macular fibrosis) is the formation of a thin, fibrotic membrane over the retina, particularly the macula (the part of the eye responsible for detailed, central vision) that contracts, wrinkling the underlying retina and interfering with vision.
What causes an epiretinal membrane?
Sometimes when the vitreous pulls away from the retina, there is microscopic damage to the retina's surface (Note: This is not a macular hole). When this happens, the retina begins a healing process to the damaged area and forms scar tissue, or an epiretinal membrane, on the surface of the retina. This scar tissue is firmly attached to the retinal surface. When the scar tissue contracts, it causes the retina to wrinkle, or pucker, usually without any effect on central vision. However, if the scar tissue has formed over the macula, our sharp, central vision becomes blurred and distorted.
What are the symptoms?
For most people, vision remains stable and does not get progressively worse. Usually, the epiretinal membrane affects one eye, although it may affect the other eye later.
What are the treatment options?
An epiretinal membrane usually requires no treatment. In many cases, the symptoms of vision distortion and blurriness are mild, and no treatment is necessary. People usually adjust to the mild visual distortion, since it does not affect activities of daily life, such as reading and driving. Neither eye drops, medications, nor nutritional supplements will improve vision distorted from epiretinal membrane. Sometimes the scar tissue (which causes a macular pucker) separates from the retina, and the macular pucker clears up.
Rarely, vision deteriorates to the point where it affects daily routine activities. However, when this happens, surgery may be recommended. This procedure is called a vitrectomy, in which the vitreous gel is removed to prevent it from pulling on the retina and replaced with a salt solution. Since the vitreous is mostly water, you will notice no change between the salt solution and the normal vitreous. Also, the scar tissue which causes the wrinkling is removed. This special vitrectomy along with removal of scar tissue is also referred to as a membrane peel. It is usually performed under local anesthesia. After the operation, the patient needs to wear an eye patch for a few days or weeks to protect the eye and also needs to use medicated eye drops to protect against infection and speed up healing.