Epiretinal Membrane

EPIRETINAL MEMBRANE

By Luis Washington Lu, M.D.

An epiretinal membrane (ERM) is a semitranslucent sheath of glial cells covering the inner service of the retinal. This ERM can be:

  • Idiopathic: secondary to Posterior Vitreous Separation (Aging) in a sensitive eye
  • Secondary to a variety of conditions including eye vascular occlusions, inflammation, trauma, intraocular surgery, and retinal breaks.

ERM’s are relatively common. I call it “the 10% disease”. Ten percent (10%) of seniors have it, it is bilateral in 10% of them, and 10% of them can proliferate in the way that may require surgery. Ten percent of those who have surgery done may require a second procedure done.

This sheath of cells has the tendency to induce contracture of the membrane inducing distortion and wrinkling of the inner surface of the retina for which the ERM is also called cellophane maculopathy or preretinal macular fibrosis, as it also has the tendency to grow over the macula which is the central part of the vision. Surface-wrinkling retinopathy and macular pucker are also terms used for the ERM depending of the severity of the case.

Further traction can cause shallow detachments, macular cysts, fluid accumulation, and macular holes.

OCT scan of normal macula vs ERM

Although rarely the ERM can be resolved, most patients may remain stable with functioning vision. But in certain cases, the vision decreases under 20/50 or 20/60, or the distortion is intolerable by the patient, then surgical removal of the membrane will have to be performed. The procedure is called Membrane Peeling through a Pars Plana Vitrectomy with Fluid-Gas exchange and it is performed by well-trained retinal surgeons.

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