What is an epiretinal membrane?

As you age, the clear, gel-like substance that fills the middle of your eye begins to shrink and pull away from the retina. In some cases, a thin “scar tissue” or membrane can grow on the surface of the macula. The membrane creates traction on the retina, resulting in distortion, blurriness, or both.

Is there treatment for an epiretinal membrane (ERM)?

If your symptoms are mild, no treatment may be necessary. If you have more severe symptoms that interfere with your daily routine, your ophthalmologist may suggest vitrectomy surgery to peel and remove the abnormal scar tissue. The amount of visual improvement varies from person to person and depends on multiple factors including the severity of the epiretinal membrane, the level of vision preoperatively, and the presence of any other ocular abnormalities. The risk of surgical intervention for mild ERMs that have little to no visual impact isn’t justified. Typically, the patient’s symptomatic course will dictate the timing of surgical intervention. In many cases, mild membranes are simply monitored over time for progression. Overall, visual improvement is seen in most eyes following ERM peeling surgery, but complete restoration of vision is rarely achieved. Following vitrectomy surgery, vision improves 2 or 3 more lines on the Snellen chart in roughly 67% to 87% of cases. Most visual recovery comes 2 to 3 months after ERM peeling, however improvement can continue for 6 to 12 months before best final vision is obtained.

What are the risk for epiretinal membrane (ERM) surgery?

In general, ERM peeling is a safe operation with few complications. The most common postoperative complication, occurring in 12% to 68% of cases, is the accelerated nuclear sclerosis (cataract) of the crystalline lens. In many eyes, vision improves for 6 to 9 months and then slowly declines as the cataract progresses. Most individuals have to undergo cataract extraction within 2 years to maximize the benefit of membrane peeling. Some of the more rare complications include, retinal detachment, recurrence of ERMs, endophthalmitis, cystoid macular edema and vitreous hemorrhage.

What are the symptoms of an epiretinal membrane (ERM)?

Symptoms, which can be mild or severe and can affect one or both eyes, may include:

Blurred detail in vision
Distorted or wavy vision
Gray or cloudy area in central vision
Blind spot in central vision

The vast majority of patients with mild epiretinal membrane are asymptomatic.

What causes an epiretinal membrane (ERM) and who at risk?

An epiretinal membrane often occurs as part of the aging process following a posterior vitreous detachment (PVD). It is not understood why some people are more inclined than others, however, epiretinal membranes can also be associated with other eye conditions such as diabetic retinopathy, eye inflammation (uveitis), trauma and retinal detachment.

How are epiretinal membranes detected?

Optical coherence tomography (OCT) is a non-invasive imaging test which uses light waves to detect areas of macular thickening or thinning. This scan can confirm if an epiretinal membrane is present and highlights the affected areas. OCT is also often used to monitor membrane development.

Epiretinal Membrane (ERM)