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[Recurrence of an idiopathic vasocentric epiretinal membrane: clinical and surgical particularities]
O Sandali1, E Basli, V Borderie
1Centre Hospitalier National d'Ophtalmologie des XV-XX, 28, rue de Charenton, 75571 Paris, France. sanotman1@yahoo.fr
Abstract:
The vasocentric epiretinal membranes (ERM) are idiopathic ERM centered on retinal blood vessels, described mainly in young patients. We report a case of a 70-year-old patient who presented with a decrease in visual acuity secondary to a vasocentric epiretinal membrane. A successful vitrectomy and ERM removal were performed. Four years after surgery, a contractile ERM centered on the superior temporal blood vessel occurred and was associated with retinal distortions at the posterior pole. The second surgery combined removal of the recurrent ERM, which was adherent to the temporal vessels, and peeling of the internal limiting membrane in the macular area. Although there was visual recovery, the patient is still suffering from metamorphopsia 2 years after surgery. The vasocentric ERM have a poor visual outcome and a high risk of recurrence in comparison with other ERM disorders. This case report describes the main clinical and surgical characteristics of this type of membrane.
Insights
Vasocentric epiretinal membranes (ERM) typically affect younger patients but can recur in older individuals. This case highlights the challenges and poor visual outcomes associated with vasocentric ERM, even after repeat surgery.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Surgical Case Reports
Background:
- Idiopathic epiretinal membranes (ERM) are fibrocellular membranes on the retinal surface.
- Vasocentric ERM are a subtype characterized by their adherence to retinal blood vessels.
- These membranes are predominantly reported in younger individuals.
Observation:
- A 70-year-old patient presented with decreased visual acuity due to a vasocentric ERM.
- Initial vitrectomy and ERM removal were successful, but the membrane recurred 4 years later.
- The recurrent ERM was contractile, adherent to temporal vessels, and caused posterior pole distortion.
Findings:
- Recurrent vasocentric ERM can occur in elderly patients, contrary to typical presentation.
- Surgical management, including repeat vitrectomy and internal limiting membrane peeling, led to partial visual recovery.
- Despite surgical intervention, the patient experienced persistent metamorphopsia, indicating significant visual impairment.
Implications:
- Vasocentric ERM are associated with a poorer visual prognosis and higher recurrence rates compared to other ERM.
- This case underscores the complex clinical and surgical management challenges posed by vasocentric ERM.
- Further research into the pathogenesis and optimal treatment strategies for vasocentric ERM is warranted.
