Epirerinal Membrane (ERM)causes, symptoms and treatments

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Last updated 9/29/2019
ABOUT ERM (EPIRETINAL MEMBRANE), Macular pucker, Assil Eye Institute Los Angeles

What's Epiretinal Membrane (ERM or Macular Puckers)?

Epiretinal membrane (ERM) has many names including macular pucker, cellophane retinopathy and retinal wrinkling.

 

The retina is the tissue lining the inside of the back of your eye. A normal retina consists of 10 microscopic layers. Epiretinal membrane is an 11th layer that forms on the surface of the central retina known as the macula.

 

An ERM is a very thin transparent tissue, which is technically a delicate scar from an abnormal healing response inside the eye.

Symptoms of epiretinal membrane?

Epiretinal membranes can develop after eye trauma, a retinal detachment, or in patients with inflammatory conditions of the body. But most commonly, they happen in otherwise completely healthy eyes, and their true origin is not well understood.

 

Epiretinal Membranes are painless and very slow growing (over months to years). And so, the vast majority of patients with ERM have no symptoms and their ERM´s are discovered incidentally during a routine eye exam. However, as the membrane gradually increases in size, central vision quality may decrease.

 

To an eye which has an ERM, horizontal or vertical lines may appear wavy or bent. Blurred vision and decreased visual acuity can also occur. The extent of symptoms from an ERM can vary greatly, depending on its size and its precise location in the macula.

 

How's ERM diagnosed? 

Diagnosis of an ERM requires a dilated eye exam that permits close examination of the retina as well as an imaging study called an OCT (ocular coherence tomography) that uses light waves to take cross-section pictures of the retina.

 

How's epiretinal membrane treated?

The great majority of ERMs are very slow growing and have minimal visual impact. That´s why they are usually monitored over time with one to two retinal exams per year. As the membrane grows, more frequent monitoring becomes necessary, particularly if visual symptoms increase.

 

Because there are no eye drops, medications or supplements that can remove an epiretinal membrane, the only treatment option is surgery.

 

The surgery to remove an epiretinal membrane is called a Vitrectomy. It is a very delicate procedure because the membrane is thinner than a human hair. Tiny instruments are used to remove the vitreous gel filling the inside of the eye and replace it with specialized saline to maintain eye pressure.

 

Next, a special tweezer-like instrument is used to peel off this thin extra layer from the surface of the retina. No further treatment is needed for the majority of ERM patients because, once removed, an ERM typically does not grow back.

How successful is Vitrecotomy Surgery for ERM?

Epiretinal membrane peels have a very good success rate and most patients achieve improved visual acuity with reduced distortion. However, the visual recovery following this surgery is not immediate.

 

Because ERM develops over many months, it takes time for the retinal tissue to relax and resume its normal anatomic shape after surgery. Depending on the size and age of the ERM, in some cases restoring vision to normal is not possible.

 

Why treat ERM at Assil Eye Institue?

The AEI staff includes a highly skilled retina specialist Dr. Svetlana Pilyugina or “Dr. P”, as she is known to her patients.

 

Dr. Pilyugina is an ophthalmologist with fellowship training and board certification in diseases and surgery of the vitreous and retina. She and her team have extensive experience in the medical management and surgical treatment of macular disease.

 

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