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Epimacular Inverted Retinal Flap Simulating an Epiretinal Membrane.

Jay C Wang, Yodpong Chantarasorn, Thanos D Papakostas

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    A rare epimacular inverted flap mimicked an epiretinal membrane in a patient with persistent macular edema. Surgical removal of the flap resolved the condition, emphasizing preoperative imaging review.

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    Area of Science:

    • Ophthalmology
    • Retinal Surgery
    • Medical Imaging

    Background:

    • A 66-year-old male presented with visually significant epiretinal membrane (ERM) and persistent cystoid macular edema post-surgery for retinal detachment with proliferative vitreoretinopathy.
    • Preoperative optical coherence tomography revealed a thick, vascularized membrane, suggesting a complex ERM.

    Observation:

    • Intraoperative findings during vitrectomy identified the "membrane" as an inverted retinal flap, not a true ERM.
    • The inverted retinal flap was successfully removed during the vitrectomy procedure.

    Findings:

    • The inverted retinal flap is believed to have resulted from retinal slippage during previous surgical interventions.
    • This case represents the first documented instance of an epimacular inverted flap mimicking an ERM.

    Implications:

    • Accurate preoperative imaging analysis is crucial for differentiating between ERMs and unusual retinal configurations.
    • This finding underscores the importance of meticulous surgical planning and intraoperative vigilance in complex retinal cases.
    • Recognizing inverted retinal flaps can prevent misdiagnosis and guide appropriate surgical management, improving patient outcomes.