Macular epirretinal membrane
"The macular epirretinal membrane is a fairly common pathology, which can affect up to 8% of the population over 60 years of age but only requires treatment in symptomatic cases".
DR. MANUEL SÁENZ DE VITERI VÁZQUEZ
SPECIALIST. OPHTHALMOLOGY DEPARTMENT
The macular epirretinal membrane is a condition in which a thin layer of scar tissue forms on the surface of the retina, in the region where vision is most acute (the macula).
When formed, this membrane can contract and wrinkle the macula causing distortion and/or blurred vision.
It is a fairly common pathology, affecting up to 8% of the population over 60 years. In many cases it is asymptomatic and is detected during a routine check-up. But, sometimes it can worsen, causing distortion or blurred vision. Surgery would only be indicated in symptomatic cases.
We have advanced technology for the diagnosis of the epirretinal membrane, such as wide field fundus cameras and different OCT models, including angiography by OCT that allows, in a matter of seconds, to visualize with a maximum degree of detail, the different vascular plexuses of the retina, without the need to use contrast media.
Our team of retinal surgeons has extensive experience in the management of macular epirretinal membrane complications.
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What are the symptoms of the macular epirretinal membrane?
The macular epirretinal membrane is, most of the time, asymptomatic. But when it contracts and wrinkles the macula can cause decreased vision, blurred vision and/or distortion (we would see straight lines or wavy or curved letters).
The most common symptoms are:
- Decreased visual acuity.
- Distorted vision.
Do you have any of these symptoms?
You may have a macular epirretinal membrane
What are the causes of the epirretinal membrane?
In most cases the appearance of an epirretinal membrane is related to the normal aging of the vitreous gel that usually leads to a later vitreous detachment.
When this vitreous detachment occurs, cells coming from the retina, the pigment epithelium or the vitreous cortex itself may be deposited on the macula. These proliferate forming a fibrotic mesh that can contract.
In other cases it may be related to pathologies such as diabetes, retinal vein obstruction, inflammation, after surgery or laser of the retina.
How is the epirretinal membrane diagnosed?
Since most of the time it is asymptomatic, many times we detect them during a routine ophthalmological exam in which we do a fundus under pupil dilation.
With an optical coherence tomography (OCT), apart from confirming the diagnosis we can evaluate what effect the contraction of the membrane is having on the different layers of the retina.
How is the epirretinal membrane treated?
In symptomatic cases, treatment of the macular epirretinal membrane is surgical.
It is a type of microsurgery that is performed under a microscope, making 3 small incisions in the white part of the eye, through which very fine instruments are inserted.
First the vitreous gel is removed (vitrectomy), and then the epirretinal membrane is peeled from the surface of the retina. We may also choose to peel a thin layer of the retina (the internal limiting membrane) in the macular area since, although it has not been shown to improve the functional outcome, it has been shown to reduce the rate of recurrence of the epirretinal membrane. In most cases it is not necessary to use gas or position the patient.
Normally, after surgery, vision is more blurry and may take months to improve to its definitive level.
The goal of surgery is to reduce distortion, and usually if we are successful in doing so. In contrast, the improvement in vision is less predictable. But even if it does not improve, the surgery does prevent the membrane from further deteriorating vision.
Where do we treat it?
IN NAVARRE AND MADRID
The Department of Ophthalmology
of the Clínica Universidad de Navarra
Equipped with the latest technology, the Department of Ophthalmology has the necessary equipment, both technical and human, to offer comprehensive and specific assistance to each patient.
We are one of the few centers that have a microsurgery laboratory for the improvement of clinical practice.
Organized in specialized units
- Cornea and eye surface
- General Ophthalmology
- Refraction defects
- Pediatric ophthalmology
Why at the Clinica?
- More than 30 years of experience.
- Experts in the diagnosis and treatment of ocular pathologies.
- With the security and guarantee of a prestigious hospital.