Epiretinal membrane

An epiretinal membrane (ERM) is a thin transparent tissue that forms on the surface of the retina.  The membrane can be secondary to:

    • Spontaneous separation of vitreous gel inside the eye

    • Wide variety of conditions such as blood vessel damage, inflammation, trauma, surgery, and retinal breaks.

Approximately 2% of patients over 50 have ERM.

Signs and symptoms

ERM is usually located in the center of the retina, the macula.  In early stages, the membrane is thin and difficult to detect with very little, if any, symptoms.  Over time, the membrane may become thicker, which then cause the underlying retina to become distorted and wrinkled.  Further changes can lead to swelling, hemorrhage, and even detachment of the retina.  Symptoms include decreased vision, distortion, wavy lines, and double vision.  In many patients, however, the ERM can remain stable for a long time without much change in vision.  Diagnosing ERM requires a dilated retinal exam along with special testing such as fluorescein angiogram and optical coherence tomogram.

Treatment

Most patients have mild symptoms and do not require treatment right away.  For patients with significant symptoms, surgical removal of ERM is may be indicated.  Pars plana vitrectomy is the surgical technique used to peel the ERM by making micro-incisions into the vitreous cavity and using a variety of instruments to remove the membrane from the surface of the retina.  It is performed in the operating room, either under local or general anesthesia.

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