Introduction
Epiretinal Membrane (ERM), also known as macular pucker or cellophane maculopathy, is a thin, transparent layer of scar-like tissue that forms on the macula—the part of the retina responsible for sharp, central vision. While ERM can be mild and may not significantly affect daily life, in some cases, it can cause blurred or distorted vision, interfering with tasks such as reading or recognising faces.
At The Retina Clinic London, we specialise in the diagnosis and treatment of ERM. Our team combines world-class expertise with advanced imaging and surgical techniques to preserve and restore your vision.
What Causes Epiretinal Membrane?
ERM is commonly associated with age-related changes in the vitreous, the gel-like substance that fills the centre of the eye. As the vitreous shrinks and detaches from the retina (a process called posterior vitreous detachment, PVD), it can sometimes stimulate scar tissue formation on the macula, leading to an ERM.
Other contributing factors include:
- Eye Conditions or Injuries: Retinal tears, retinal detachment, or trauma can increase the risk of ERM.
- Eye Inflammation (Uveitis): Inflammation within the eye can trigger scar tissue formation.
- Diabetic Retinopathy or Retinal Vein Occlusion: These conditions affecting retinal blood vessels can lead to ERM development.
- Previous Eye Surgery: Procedures such as cataract surgery may slightly increase the likelihood of an ERM forming.
Symptoms of Epiretinal Membrane
The symptoms of ERM vary depending on the thickness of the membrane and its impact on the macula. Common symptoms include:
- Blurred Vision: Reduced clarity, making it harder to focus.
- Distorted Vision (Metamorphopsia): Straight lines may appear bent or wavy.
- Difficulty with Detail: Challenges with activities such as reading fine print or recognising small objects.
- Reduced Contrast Sensitivity: Colours and contrasts may appear muted.
- Monocular Double Vision: Less commonly, individuals may experience double vision in one eye.
If you notice any of these symptoms, a comprehensive evaluation is essential to confirm the cause and determine the best course of action.
How is Epiretinal Membrane Diagnosed?
At The Retina Clinic London, we use cutting-edge diagnostic technologies to assess and monitor ERM. These include:
- High-Resolution Macula Optical Coherence Tomography (OCT): This advanced imaging technique provides detailed cross-sectional images of the retina, allowing us to assess the thickness of the membrane and its impact on the macula.
- Ultrawidefield Fundus Imaging: Captures detailed images of the entire retina to identify any associated conditions that may contribute to ERM development.
- Ultrawidefield Optical Coherence Tomography (OCT): Evaluates the peripheral retina to check for other potential causes or complications.
Our comprehensive diagnostic approach ensures an accurate diagnosis and helps guide personalised treatment plans.
Treatment Options for Epiretinal Membrane
The best treatment option depends on the severity of your symptoms and how significantly the ERM is affecting your vision:
1. Monitoring
For mild cases where the ERM does not significantly impact vision, regular monitoring may be sufficient. Follow-up imaging with OCT allows us to track any changes over time and determine if treatment becomes necessary.
2. Surgery – Vitrectomy
For more severe cases where vision is noticeably blurred or distorted, surgical intervention may be required. A full vitrectomy is the standard treatment for ERM and involves:
- Removing the vitreous gel to eliminate any traction on the macula.
- Carefully peeling away the epiretinal membrane, relieving tension and allowing the macula to regain its natural shape.
At The Retina Clinic London, we perform vitrectomy surgery in our onsite operating theatre, equipped with the latest operating microscope and cutting-edge surgical technology. This ensures the procedure is performed with the highest level of precision and care, optimising the chances of restoring your vision to normal.
Our experienced surgeons will discuss the expected visual recovery with you before surgery, considering factors such as the severity and chronicity of your ERM. This personalised approach ensures you have realistic expectations about the outcome of the procedure.
What to Expect After Surgery
Recovery following vitrectomy for ERM is typically straightforward, but it’s important to follow the aftercare plan provided by our specialists to ensure the best outcome. At The Retina Clinic London, we provide a comprehensive follow-up programme to monitor your recovery and the success of the surgery.
- Healing and Vision Recovery: Vision often improves gradually, with most patients noticing significant improvement over six months as the retina settles.
- Personalised Follow-Up: We schedule regular follow-up visits to track your progress using high-resolution macula OCT and other advanced imaging techniques. This ensures any concerns are addressed promptly.
- Aftercare Support: You will be prescribed eye drops to prevent infection and inflammation, and our team will provide clear guidance on activity restrictions during your recovery.
While some residual distortion may persist in advanced cases, most patients experience a significant improvement in their vision and quality of life.
Why Choose The Retina Clinic London for ERM Treatment?
At The Retina Clinic London, we provide world-class care for patients with ERM, combining expertise, advanced technology, and a personalised approach.
Why Patients Trust Us
- World-Leading Expertise: Led by Professor Paulo Stanga, an internationally recognised retinal specialist, our team offers unmatched experience in diagnosing and treating ERM.
- Comprehensive Diagnostics: Using advanced imaging tools such as high-resolution OCT, ultrawidefield fundus imaging, and ultrawidefield OCT, we provide a precise and complete assessment of your condition.
- Onsite Operating Theatre: Our state-of-the-art surgical suite is equipped with the latest technologies, including a premium operating microscope, enabling us to perform vitrectomy with the highest precision.
- Tailored Treatment Plans: We create bespoke care plans based on your specific condition and visual needs, ensuring optimal outcomes.
- Dedicated Aftercare: Our comprehensive follow-up programme ensures that your recovery is carefully monitored, giving you peace of mind throughout the process.
If you are experiencing symptoms of an epiretinal membrane or have been diagnosed with the condition, contact The Retina Clinic London today. Our team is dedicated to restoring and preserving your vision with expert care and the latest advancements in retinal treatment.
