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Macular epiretinal membranes
C J Pournaras1, G Donati, P D Brazitikos
1Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
Abstract:
Epiretinal membranes (ERM) are a common finding in older patients. Although they may be associated with numerous clinical conditions, most epiretinal membranes occur in the absence of ocular pathology. Patients symptoms range from asymptotic to complaints of severe vision loss and metamorphopsia. Epiretinal membranes are commonly classified according to their density, to the severity of retinal distortion and to associated biomicroscopic changes. Pars plana vitrectomy has been found to be effective in removing ERM from the macula, improving the visual acuity and decreasing metamorphopsia. Both idiopathic and secondary ERMs do well after surgery, although secondary ERMs showed a greater amount of improvement than idiopathic ones. Complications are frequent including accelerated postoperative nuclear sclerosis, retinal breaks and RD, macular edema, RPE and, occasionally, macular hole and hypotony. However only RD involving the macula have a worsening prognosis on final outcome.
Insights
Epiretinal membranes (ERM) are common in older adults, often without eye disease. Pars plana vitrectomy effectively removes ERMs, improving vision and reducing visual distortion, with secondary ERMs showing greater improvement.
Area of Science:
- Ophthalmology
- Retinal Diseases
Background:
- Epiretinal membranes (ERM) are prevalent in older individuals.
- Most ERMs occur without underlying ocular pathology.
- Symptoms vary from asymptomatic to significant vision loss and metamorphopsia.
Purpose of the Study:
- To evaluate the efficacy of pars plana vitrectomy in managing epiretinal membranes.
- To compare outcomes between idiopathic and secondary ERMs post-surgery.
Main Methods:
- Pars plana vitrectomy for ERM removal from the macula.
- Classification of ERMs based on density, retinal distortion, and biomicroscopic changes.
Main Results:
- Pars plana vitrectomy effectively improves visual acuity and reduces metamorphopsia.
- Secondary ERMs demonstrated greater visual improvement compared to idiopathic ERMs.
- Common complications include nuclear sclerosis, retinal breaks, macular edema, and hypotony.
Conclusions:
- Pars plana vitrectomy is an effective surgical treatment for epiretinal membranes.
- While complications can occur, most do not significantly impact the final visual outcome.
- Retinal detachment involving the macula is associated with a poorer prognosis.