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Epiretinal Membrane

An epiretinal membrane, also called a macular pucker, premacular fibrosis, surface wrinkling retinopathy or cellophane maculopathy, is a thin film of fibrous tissue that forms over the macula (central part of the retina, the light receptive tissue at the back of the eye). The macula is responsible for sharp central vision required for reading, driving etc. An epiretinal membrane causes blurred and distorted central vision.

As we grow older, the thick vitreous (a clear gel like substance located between the crystalline lens and the retina) inside the eye begins to shrink and pull away from the retina. As the vitreous pulls away, small pieces of tissue or cells from the retina and other tissues in the eye are released into the vitreous gel that eventually settle on the macula. These cells start proliferating and form a thin sheet over the macula.

In most cases, an epiretinal membrane occurs in an eye with no history of eye problems. Occasionally however, an epiretinal membrane can develop as a consequence of previous eye disorders such as detachment of retina from its underlying layers of tissue, eye trauma, inflammatory disease, blood vessel abnormality or other conditions.

An epiretinal membrane is usually a mild eye condition with little or no effect on vision. However, sometimes, the epiretinal membrane grows slowly over time and cause wrinkles in the macula that leads to blurring or distortion (straight lines may appear wavy) in the central vision that may worsen. An epiretinal membrane does not cause complete blindness as it affects only central vision with peripheral vision remaining unaffected.

To diagnose an epiretinal membrane, the doctor will instil eye drops and dilate your pupils to view the retina. The degree of vision affected by an epiretinal membrane is assessed with an Amsler Grid (a grid of horizontal and vertical lines). A test called optical coherence tomography (OCT) is performed that uses a laser camera to capture pictures of the retina to record its anatomy, thickness, and wrinkles caused by the epiretinal membrane. Another test called fluorescent angiography may be considered occasionally.

Treatment is not required for a mild epiretinal membrane that has very little or no effect on vision. However, when vision declines, surgery is the only treatment option available. ‘Vitrectomy’ is the surgical procedure performed to remove the epiretinal membrane.