Epiretinal Membrane

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  • = macular pucker
  • fibrocellular tissue on the inner surface of the retina / inner limiting membrane (ILM)


  • idiopathic in most cases
  • Secondary to diabetic retinopathy, vein occlusion, inflammatory diseases, trauma, intraocular surgery, tumours, retinal tear or retinal detachment.


  • Symptoms: Metamorphopsia, monocular diplopia, micropsia; however, often asymptomatic
  • Fundus examination: Shimmery reflectivity in the area of the macula, wrinkling, loss of foveal reflex
  • OCT: Membran? Foveal retinal thickness? Ellipsoid zone intact?


  • Surgery (pars plana vitrectomy + membrane peeling ± ILM peeling)
    • Indication for surgery strongly dependent on patient’s symptoms
      • When did the symptoms start? Better outcome if symptoms < 1 year
      • Metamorphopsia? Binocular disturbance? Quality of life?
      • Visual acuity ≤0.5 (rough guide), a higher preoperative visual acuity is associated with a better outcome
    • Postoperative visual recovery can take 6-12 months
  • In case of doubt, “watchful waiting”, only plan surgery if visual acuity deteriorates


  • EyeWiki Epiretinal Membrane
  • Prognostic factors of epiretinal membranes: a systematic review, A. I. M. Miguel and A. Legris; Journal Français d’Ophtalmologie, vol. 40, no. 1, pp. 61–79, 2017.
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Nika Bagheri MD, Brynn Wajda MD, et al; Lippincott Williams&Wilkins; 7th Edition (2016)
  • Kanski’s Clinical Ophthalmology: A Systematic Approach; Jack J. Kanski MD, Brad Bowling MD; Saunders Ltd.; 8th Edition (2015)