Epiretinal Membrane: causes and treatment

What is an Epiretinal Membrane?

An Epiretinal Membrane (ERM) is a fine sheet of scar tissue that forms on the surface of the retina, the delicate layer of cells at the back of the eye responsible for capturing light and enabling sight. This membrane can resemble a cloudy film, like cellophane, that can crinkle and distort the retina. When an ERM develops on the central part of the retina, called the macula, it can cause blurring and distortion of vision.

Symptoms of Epiretinal Membrane

The impact of an epiretinal membrane on vision can range from mild to severe. Common symptoms include:

• Blurred vision
• Distorted vision, where straight lines may appear wavy
• Difficulty reading small print
• Only noticing symptoms when covering the other eye

Causes of Epiretinal Membrane

The primary cause of an epiretinal membrane is the natural ageing process, where changes in the vitreous gel lead to its separation from the retina, known as posterior vitreous detachment (PVD). This detachment can stimulate the formation of scar tissue on the retinal surface. Other potential causes include:

• Retinal tears or detachment
• Retinal vein occlusion
• Inflammation of the eye (uveitis)
• Eye trauma or previous eye surgery

Assessment and diagnosis

An epiretinal membrane must be evaluated by a retinal specialist. The assessment includes:

• A comprehensive eye examination with pupil dilation
• Imaging of the retina using Optical Coherence Tomography (OCT) to assess the severity of the ERM
• Additional tests like retinal colour imaging and fundus fluorescein angiography may be required

Treatment options for Epiretinal Membrane

There are two primary approaches to managing an epiretinal membrane:

1. Monitoring: If the ERM causes minimal or no vision changes, regular monitoring may be sufficient. Many ERMs remain stable over time without significantly affecting vision.

2. Vitrectomy surgery: For significant vision impairment or progressive symptoms, vitrectomy surgery may be recommended. This procedure involves:

• Creating micro-incisions in the white of the eye to remove the vitreous gel
• Gently peeling the ERM off the retina with fine micro-forceps
• Sometimes using an air or gas bubble to aid recovery
• Possibly performing cataract surgery concurrently

For more detailed information on vitrectomy and post-operative care, visit our vitrectomy page.

Conclusion

Understanding epiretinal membrane causes, symptoms, and treatment options is crucial for maintaining eye health. Early detection and appropriate treatment can significantly improve outcomes.