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    Epiretinal membranes (ERM), also called macular pucker and cellophane maculopathy, are a common finding in patients by eye care specialists.  As you would expect from the name, these are membranes that grow on the surface of the retina.  This scar tissue grows across the macula and the center of vision.  The ERM then contracts, distorting the retina, and therefore distorting the vision as well. Many patients will notice that straight objects such as telephone poles, door jams, etc. develop a distorted view or they may just note total central distortion of the vision, depending on the severity of the macular pucker.

     Epiretinal membranes can be associated with a variety of eye disorders but most commonly are not associated with anything (what we call idiopathic). Eye disorders that can be associated with epiretinal membranes include eye trauma, retinal tears, retinal detachment surgery, inflammations of the eye, blood vessel problems including BRVO and CRVO and many other disorders .

ERM Epiretinal membrane (just below fovea) causing straightening of vessels and distortion of the center of vision with significant vision loss.

    As opposed to many of the other diseases discussed in this website, there is really only one treatment for an epiretinal membrane, vitrectomy and membrane peeling.  If the ERM causes only mild distortion and visual loss, no therapy may be indicated.   If, however, the vision is significantly decreased and is causing major problems for the patient, then vitrectomy surgery is the indicated treatment.

NORMAL OCT In a normal OCT (Ocular Coherence Tomogram) there is a smooth contour to the surface of the retina with a foveal depression in the center.

OCT: ERM and VMT Epiretinal membrane with VitreoMacular Traction (VMT) and membrane markedly contracting and elevating retina shown in this cross section on OCT (Ocular Coherence Tomogram).

Surgery consists of making three small incisions in the eye.  An infusion cannula (tube) is connected to one of the incisions that puts fluid into the eye and through the other two incisions instruments are used to first remove the vitreous jelly from the eye and then very small forceps, scissors and diamond dusted instruments are used to remove the membrane from the surface of the retina. Fortunately, epiretinal membrane surgery is very highly successful with improvement of vision in most patients. Vitrectomy and membrane removal does not immediately improve vision in some patients, however, most improve in the first 3-6 months after surgery and can improve for a year or more following surgery.  In some cases the vision may not improve due to damage done by the distortion of the membrane and damage to the retina and Cystoid Macular Edema (CME) however, the chance of visual improvement is approximately 80-90%. Complications of epiretinal membrane surgery are those for any vitreous surgery and include bleeding, infection, retinal detachment, and cataract progression.  Recurrence of the membrane itself occurs in approximately 10% of patients. All of these complications are fortunately rare with this surgery.

Disclaimer Stuff: The opinions expressed in this website are those of RVT.  Diagnosis and therapy should be based on a thorough examination by and recommendations of a qualified eye provider.