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Epiretinal Membrane

Epiretinal membranes (ERM), also commonly referred to as macular pucker or wrinkles, are fibrocellular membranes that form on the surface of the retina. They are caused by a defect in the inner layer of the retina that allows glial cells to migrate through and proliferate on its surface. They are often associated with a posterior vitreous detachment, but can also be seen in eyes with prior retinal tears, inflammation, diabetic retinopathy, or vein occlusion. They are often idiopathic, meaning there is no specific cause found. Most commonly, they are fairly stable after an initial period of growth and can be observed. However, if the exam shows progression or significant visual disturbance, surgical intervention may be necessary as medical treatment does not treat ERMs.
A surgical procedure called a vitrectomy, in which small incision are made in the white part of the eye, is performed and the vitreous gel inside the eye is replaced with saline. Special stains are used to delineate the membrane and it is gently removed from the surface of the retina with delicate forceps. This allows the macula to relax and become less wrinkled. Factors that affect the final visual outcome include the length of time the ERM has been present and the degree of traction.
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