Epiretinal Membrane

epiretinal-membrane

Epiretinal membrane is a disease of the eye in response to changes in the vitreous humor or more rarely, diabetes.

Epiretinal membrane is a disease of the eye in response to changes in the vitreous humor or more rarely, diabetes.
It is also called macular pucker or cellophane maculopathy, are avascular (having few or no blood vessels), semi translucent, fibro-cellular membranes that form on the inner surface of the retina.

Most epiretinal membranes happen because the vitreous (the jelly inside the eye) pulls away from the retina.  This most commonly happens to people over the age of 50.  The membrane may also form following eye surgery or inflammation inside the eye.

Sometimes, as a result of immune system response to protect the retina, cells converge in the macular area as the vitreous ages and pulls away in posterior vitreous detachment (PVD). PVD can create minor damage to the retina, stimulating exudate, inflammation, and leukocyte response.

These cells can form a transparent layer gradually and, like all scar tissue, tighten to create tension on the retina which may bulge and pucker, or even cause swelling or macular edema.

While the scar tissue is developing, it does not appear to affect your vision.  However, when it stops growing, it contracts (shrinks) and causes distortion of your central vision – for example, straight lines appear wavy or crooked in appearance, and reading is difficult.  Depending on the severity of this distortion, you might notice a substantial loss of central vision.

This is a clinical diagnosis based on history and clinical exam, including slit lamp and dilated fundus examination. In some cases, Optical Coherence Tomography (OCT) is useful in the diagnosis and management of this condition.

There are no preventative measures for idiopathic ERMs. The risk of secondary ERMs can be reduced in some cases by appropriately manage the underlying cause.

Partial correction often improves the binocular vision considerably though. In the young (under 50 years of age), these cells occasionally pull free and disintegrate on their own; but in the majority of sufferers (over 60 years of age), the condition is permanent. The underlying photoreceptor cells, rod cells, and cone cells are usually not damaged unless the membrane becomes quite thick and hard; so usually there is no macular degeneration.

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