Macular Pucker / Epiretinal Membrane (ERM)
What is a Macular Pucker / Epiretinal membrane (ERM)?
A macular pucker, also known as epiretinal membrane (ERM) is a condition that impacts that macula, which is the central area of the retina where fine-detail vision for reading, recognizing faces, and driving is located. A macular pucker can occur following a natural process of vitreous gel separation that occurs with age. During this process of vitreous separation, a fine tissue can develop on the surface of the macula leading to wrinkling and swelling of the macula.
What are symptoms of a macular pucker?
Symptoms can range from patients being asymptomatic to having distorted vision and blurry vision. The extent of the symptoms generally is related to the severity of the wrinkling and swelling of the macula.
What are the causes of a macular pucker?
Macular puckers are most commonly a result of the aging process as the vitreous gel undergoes separation with increasing age. It is also more common in patients with diabetic retinopathy, retinal vein occlusion, uveitis (ocular inflammation), or in patients who have had prior intraocular surgery.
How is a macular pucker diagnosed?
Optic coherence tomography (OCT) is a device that provides a cross sectional image of the retina that can help diagnose the presence, severity and any future progression of the macular pucker. These images are routinely obtained during your office visit with a retina specialist.
What are the treatments of a macular pucker?
The majority of patients with a macular pucker can be safely observed. Patients will be asked to monitor their symptoms at home using a special grid, an amsler grid which can help determine any worsening of symptoms. In patients with a worsening macular pucker and symptoms of distortion, vitrectomy surgery with removal of the macular pucker can be performed. This procedure usually improves distortion and difference in image size, but mild symptoms may persist. It is important to discuss with your surgeon the symptoms and level of difficulty that you are experiencing to decide whether surgery is right for you.