EPIRETINAL MEMBRANE

What is an epiretinal membrane?
An epiretinal membrane (also known as cellophane maculopathy and macular pucker) is a fine sheet of tissue that forms on the inner surface of the retina.

Who is affected by this condition and how?
Men and women are affected equally. Although the majority of the cases are idiopathic (i.e. there is no known reason for the development of the epiretinal membrane), it can also be linked to posterior vitreous detachment, previous laser treatment, inflammation, trauma etc. It is more common over the age of 60.

What are the symptoms?
Epiretinal membranes, when they are very fine and do not distort the architecture of the retina, do not cause any symptoms and do not require treatment. They do not necessarily progress.
If the epiretinal membranes are thicker and affect the retinal structure, they can cause blurred and distorted vision. Usually the symptoms are gradual and over time can worsen. Those patients might benefit from surgery.

How are epiretinal membranes treated?
The treatment of epiretinal membranes is surgical. The surgery consists of removal of the vitreous gel and gently peeling the membrane away from the retina. This surgery is called pars plana vitrectomy with epiretinal membrane peel. It can be combined with cataract surgery. Sometimes at the end of the operation a special gas bubble might be inserted. Following the operation, patients are also given some postoperative drops to use for approximately 4 weeks. The success of the surgery depends on the etiology of the epiretinal membrane and the duration of the symptoms. Although the majority of patients notice an improvement of their symptoms, it usually takes about 6 months to achieve the best result.

Anaesthesia for your operation.
The surgical procedure is usually performed under local anaesthetic as a day case, which means that the patient is fully awake during the surgery and can go home afterwards. A local anaesthetic is injected around the eye and for the duration of the surgery the patient is asked to keep still and lie on his/her back. The average time of the procedure is one hour. Alternatively, the surgery can be performed under general anaesthesia, the patient is asleep; however, that might require further investigations to assess the patients’ general health.

What happens if no surgery is undertaken?
Epiretinal membranes that cause no visual symptoms if left untreated occasionally (over a long period of time) might progress to cause distortion and blurred vision. All epiretinal membranes affect the central vision and therefore the peripheral vision remains intact.
If the epiretinal membranes have caused deterioration of the vision and no surgery is undertaken, the vision will remain blurred and/or distorted in the affected eye and might get worse overtime.