Epiretinal membrane (ERM) is a semi-clear membrane that can form over your retina’s inner surface. It often causes minimal symptoms, but some people have vision loss or distorted vision.
Your retina is a special layer of cells at the back of your eye that converts light to electrical signals your brain can interpret. Problems with your retina can cause vision loss.
ERM usually develops when the jelly-like substance inside your eye pulls away from your retina. It’s usually diagnosed in people older than age 50 years, but some younger people also develop ERM, especially after surgery or eye trauma.
Let’s look at ERM in more detail, including what causes it, potential symptoms, and treatment options.
What are the other names for an epiretinal membrane?
There are many
- macular pucker
- preretinal macular fibrosis
- surface wrinkling retinopathy
- epimacular proliferation
- epiretinal fibrosis
- cellophane maculopathy
ERM involves developing a semi-clear membrane inside your retina.
The risk of ERM increases with age and with some eye conditions. The most common cause is posterior vitreous detachment, where the jelly-like substance in your eye pulls away from your retina.
Some people are at a higher
Chinese ethnicity - diabetes
- high cholesterol
- retinal tears or detachment
- previous eye injuries
- previous eye surgery
- diabetic retinopathy
- posterior vitreous detachment
- ocular inflammation
Epiretinal membrane usually causes no or minimal symptoms. Some people develop painless vision loss and visual distortion.
Less common symptoms include:
- light sensitivity
- double vision
- objects appear smaller than they are
Symptoms can occur in one or both eyes.
Doctors often use Govetto’s staging system to divide epiretinal membrane into stages 1 to 4 based on the results of a type of retinal imaging called ocular coherence tomography (OCT).
Features of each
| Stage | Feature |
|---|---|
| Stage 1 | • the presence of a foveal pit — a normal pit in the middle of your retina where visual acuity is highest • well-defined retinal layers • thin ERM |
| Stage 2 | • the absence of a clear foveal pit • well-defined retinal layers |
| Stage 3 | • the absence of a clear foveal pit • well-defined retinal layers • abnormal inner foveal layers |
| Stage 4 | • the absence of a clear foveal pit • disrupted retinal layers • abnormal inner foveal layers • thick ERM |
Some people with ERM develop vision loss or distorted vision. Other
- vitreous hemorrhage, leaking of blood into the gel inside your eye
- retinal detachment
- macular hole
- accelerated cataract formation (which typically follows surgery to remove the ERM)
It’s important to get medical attention any time you notice changes to your vision or vision loss. Many different conditions can contribute to these symptoms, and the outlook is often better the quicker they’re treated.
ERMs can often be diagnosed during a routine vision exam. Many people don’t know they have it until an eye doctor examines their eye with OCT.
You might receive fluorescein angiography to see if underlying retinal problems might be contributing to the development of ERM.
Doctors can often treat ERM with regular monitoring alone since it typically stabilizes after an initial period of growth. The only known effective treatment for ERM is surgery.
Epiretinal membrane surgery
The main type of surgery used to treat ERM is called vitrectomy. During this procedure:
- Your surgeon makes a small incision in the white part of your eye near the cornea, called the sclera.
- They replace some of the vitreous gel inside of your eye with saline.
- Your surgeon can then access the surface of your retina to remove ERM with a pair of forceps.
Vitrectomy is generally a safe procedure, but about 1 in 100 people develop retinal detachment and about 1 in 2,000 develop an infection.
The outlook for people with ERM is usually good, but some people have vision loss, especially if treatment is delayed. Roughly
ERM can impair your central vision but doesn’t lead to total vision loss because only the central part of your retina is affected.
Diabetes is a risk factor for the development of ERM. Taking steps to prevent diabetes may also help you prevent epiretinal membrane.
Steps you can take to reduce your risk of developing type 2 diabetes include:
- getting regular physical activity, with at least
30 minutes of moderate exercise per day - keeping your body weight in a healthy-for-you range
- eating a nutritious diet that is low in processed sugar and saturated fat
- avoiding smoking and using tobacco products
Learn more about preventing type 2 diabetes.
How serious is epiretinal membrane?
Epiretinal membrane can affect your vision, and if left untreated, it can cause loss of central vision. It doesn’t cause complete blindness.
What is the best treatment for epiretinal membrane?
ERM is most often treated with a type of surgery called vitrectomy.
What happens if the epiretinal membrane is not removed
If your epiretinal membrane is causing visual problems, it will continue to impair your vision until it’s surgically removed.
What is the success rate of epiretinal membrane surgery?
The success rate for vitrectomy surgery used to treat ERM and other eye conditions is over 90%.
ERM is a semi-clear membrane that develops on the inner part of your retina. It often doesn’t cause symptoms, but some people may have visual distortion or vision loss.
ERM may not require treatment if you don’t have symptoms. If you do have symptoms, you may require a type of surgery called a vitrectomy. This procedure is often effective, but it comes with a small risk of serious complications like retinal detachment.