Epiretinal membrane is scar tissue that forms over the macula of the eye, causing blurring and distortion of the central vision needed for reading, driving, and fine detail work. It affects both men and women equally and is also referred to as macular pucker, preretinal membrane, cellophane maculopathy, retina wrinkle, surface wrinkling retinopathy, and premacular fibrosis. Causes
As we age, the vitreous, a gel-like material that comprises about 80% of the eye, slowly shrinks and pulls back from the retina. This is normal, and ordinarily, there is little to no adverse effects from this shrinkage except for an increase in “floaters” – small spots that appear to “float” in your field of vision. An epiretinal membrane may form on the surface of the retina as a result of a partial separation of the vitreous; when the membrane contracts, it causes distortion of the retina. Other conditions that may lead to epiretinal membrane include:
- Blood vessel problems or abnormalities, such as diabetic retinopathy;
- Torn retina or retinal detachment;
- Severe trauma to the eye either from injury or surgery;
- Inflammation inside the eye.
Epiretinal membrane typically affects one eye, but can occur in the other eye later, and can develop in an eye with no previous history of problems.
Symptoms can range from mild to severe and involve changes in the central vision such as blurriness or distortion. People affected with epiretinal membrane may experience mild visual distortion, but not enough to interrupt normal daily activities. In some cases, however, a person may have symptoms severe enough to distort or blur vision to a point where daily activities are hindered. These individuals may have trouble reading fine print or seeing detail, and straight lines may appear wavy. People with more severe symptoms may also have a gray or cloudy area in the center of their vision or even a blind spot.
Epiretinal membrane should not be confused with macular degeneration. While the symptoms are similar, macular degeneration and epiretinal membrane are two separate eye health conditions. The same is also true for a macular hole - it is a different disorder from epiretinal membrane. One of the Institute’s knowledgeable and experienced specialists will be able to tell you which of these conditions you may have.
A test called fluorescein angiography can aid in the diagnosis of epiretinal membrane. A fluorescein angiography test is administered by your eye doctor during an exam and uses dye to illuminate areas of the retina to be examined. Another excellent diagnostic test is an optical coherence tomography (OCT) test. The OCT uses a laser to scan the retina and measure its thickness. The OCT is a highly sensitive instrument that can diagnose irregularities that are undetectable in an examination or with fluorescein angiography.
Unfortunately, laser treatment, eye drops, medication, or vitamins will not help improve vision for someone with epiretinal membrane, but in many cases, treatment is not necessary. Persons affected usually experience mild visual distortion or blurriness, but not enough to cause problems in their daily lives. Sometimes, updating an eyeglasses prescription or wearing bifocals may help people with mild visual distortion. In the cases where people experience distortion or blurred vision that interferes with or precludes day-to-day activities, the recommended treatment is a surgery called vitrectomy. A vitrectomy surgery removes both the puckered or wrinkled tissue on the macula and the vitreous gel that may be pulling on it. The doctor may also insert an air or glass bubble in the eye to support healing and to seal any tears or holes. Following surgery, medicated eye drops would be administered to promote healing. Vitrectomy for epiretinal membranes often results in improved visual function.