The epiretinal membrane is a fibrocellular membrane that forms on the inner surface of the retina. Generally, the epiretinal membrane affects the macula, which is the central portion of the retina that helps us to distinguish fine details like reading and recognizing faces. While an epiretinal membrane can have minimal symptoms and can be checked every 6 months, in some cases it can lead to vision loss and metamorphopsia (visual distortion).
Epiretinal membranes form when glial cells on the surface layer of the retina migrate and start to grow in a membranous sheet on the retinal surface. The most common cause of an epiretinal membrane is a condition called posterior vitreous detachment, where the vitreous gel that fills the eye separates from the retina, causing imperceptible tears (micro-tears) and symptoms of floaters and flashes.
Photo: "Diabetic Epiretinal Membrane".
There are no eye drops, medications or injections to treat epiretinal membranes. A surgery known as a vitrectomy is the only option in eyes that require treatment. The vitrectomy procedure consists of making small incisions in the sclera (the white part of the eye), and removing the vitreous gel found inside the eye. This allows the surgeon to safely access the surface of the retina, delicately remove the epiretinal membrane with micro-forceps, and allow the macula to relax and become less wrinkled.
The risk of complications with a vitrectomy is small, with about 1 in 100 patients developing retinal detachment and 1 in 2000 developing an infection after surgery.
Photo: "Optical Coherence Tomography (OCT) of a normal eye".
Photo: "Optical Coherence Tomography (OCT) of an Epiretinal Membrane".
Factors affecting visual outcomes include:
Surgeries removing epiretinal membranes have a good success rate, and most patients experience improved visual acuity and decreased metamorphopsia.