What is an Epiretinal Membrane?

written by Dr Kenneth Fong Choong Sian on 18 October 2012

One of the retinal conditions that can affect your macula is something called epiretinal membrane (ERM). It is also known as macula pucker or cellophane maculopathy. This is a fine layer of scar tissue that grows on the surface of the macula and causes contraction (pucker) of the macula. It usually happens in people above the age of 50 years. Vitrectomy surgery is the only option to treat this condition.

 
Epiretinal membrane can make things look distorted
Most patients do not notice it until they see straight lines becoming wavy or out of shape. Your vision may be still good but objects will appear distorted when compared to the other eye. At the eye doctor, the diagnosis is confirmed with a dilated eye examination and a special test called Optical Coherence Tomography (OCT). It is caused by overgrowth of scar tissue on the surface of the retina and this may be due to previous retinal diseases like uvetis , retinal detachment, retinal hole, or trauma.
 
Treatment of epiretinal membrane
Most cases are mild and do not require treatment. However, if you are bothered by the distortion of vision or loss of vision, then vitrectomy surgery can be done to remove the ERM. This is done nowadays under local anaesthetic and without any sutures. The ERM at the macula is carefully removed with fine forceps and surgery takes less than 30 minutes. Risks of surgery are very small. To prevent recurrence, I usually also remove the inner layer of retina called the internal limiting membrane (ILM).  No special posturing is needed after surgery.
 
Recovery after vitrectomy surgery is quick and most patients can go back to normal routines within 1 week. Improvement in vision will take up to 3 months as the macula has to slowly go back to its normal shape.
 
Dr Kenneth Fong Choong Sian 
Consultant Ophthalmologist and Vitreoretinal Surgeon
Kuala Lumpur, Malaysia