Epiretinal Membranes are also known by other names likes Macular Pucker, Cellophane maculopathy, Surface wrinkling etc.
The light which enters the eye through cornea is focused over the light sensitizing tissue called the Retina. This delicate tissue converts Light energy into electrical energy which is transmitted via the Optic Nerve into Brain which interprets these signals to see the world around you.
Most of the light entering our eye is focused onto a small portion of Retina called as Macula. This is a highly sensitive portion of Retina which is responsible for detailed central vision and most of color vision. It provides the vision to read, recognize faces, drive a car etc. The rest of the retina is responsible for peripheral vision.
An Epiretinal Membrane is a scar tissue which forms over the surface of retina.
Normally the eye is filled with a collagenous substance called Vitreous. This Vitreous gel is attached to the surface of Retina. As age progresses this gel substance detaches itself from the surface of retina which is called as Posterior vitreous Detachment, as is considered a normal process of eye. In certain individuals this Vitreous separation incites a reaction on retinal Surface which responds by formation of Epi Retinal Membrane. This membrane sits on the surface of Retina which is responsible for central vision. Once this membrane contracts it causes distortion of retina and leads to vision disturbance.
An Epi-Retinal membrane in most of the cases is formed because of Vitreous gel separation from the Retina. These are termed as Primary ERM’s. On the other hand these can also be caused due to another retinal pathology such as Diabetic Retinopathy, Uveitis etc , broadly termed as Secondary ERM.
The management for either of these remains the same.
Patients with Epi Retinal Membrane can present with either some vision loss or no vision loss at all. The vision can be mildly blurred with difficulty in reading fine print. Most individuals complain of seeing straight lines as wavy or distorted. There might also be a dull area in central visual field. The vision loss due to Epi-Retinal membrane tends to remain stable over a period of time.
In most cases the vision loss is very mild and hence no treatment is recommended. If the vision distortion is affecting activities of daily routine or if there is progressive distortion of Retina sue to Epi Retinal Membrane – Surgical intervention is recommended. For the Surgery, Vitrectomy is performed, in which the Vitreous Gel is removed and replaced with Balanced solution. Along with the scar tissue causing retinal distortion is removed. Following Surgery, you will be prescribed medication for several weeks.
ERM removal is a very delicate procedure. While the vision improves in most of the cases, it might not return to normal or how it is in the better eye. The symptoms of vision distortion are remarkably reduced after the surgery. Recovery of vision can take 3-6 months during which anatomical improvement can be seen on OCT.
The most common complication of Vitrectomy is cataract formation. A patient usually will require a cataract surgery in a few months or years after Vitrectomy Other less common complications can be Retinal Detachment and eye infection.
