Epiretinal membrane, ERM / Macular pucker, film on retina - A State of Sight #105

An epiretinal membrane (ERM) is a thin abnormal layer on the surface of the retina in the back of the eye. This can cause distorted and blurred central vision as well as swelling and thickening of the retina.

Watch this episode of A State of Sight with Isaac Porter, MD to learn more about ERM and the possible treatment options.

Welcome to A State of Sight, I’m Isaac Porter and this is your update in ophthalmology and eye care from Raleigh.  Today, I would like to explain epiretinal membranes because this can be a common problem. By some estimates, more than 20% of people over age 75 will have some degree of an epiretinal membrane (ERM).
This is a thin film that can cover the retina in the back of the eye. Usually it’s in the center of the retina which is responsible for our central vision (the macula). Often, this may occur spontaneously with a growth or a thin film of fibrous tissue and cells that covers the front of the retina.
Epiretinal membranes can also develop after an injury, after an episode of inflammation of the eye, or after eye surgery. However, a lot of times an ERM just comes up on its own.  
When patients develop an epiretinal membrane, they may notice distortion in their vision where lines that should look straight may look waved or curvy. They may also notice double vision in one eye from the membrane or that their vision has decreased due to the membrane.
Fortunately there are treatments available for ERMs. We can refer to our retina colleagues and they can evaluate the membrane to determine if it may need surgical removal in order to improve vision. Most of these patients gain a significant amount of vision after the membrane is removed and the distortion of the retina is relieved.
Patients may not recover 100% of their vision that they had before the membrane developed but often it is close. If patients do not have surgery, the membrane can worsen over time, but other times it can stay stable.
An epiretinal membrane can cause thickening or swelling of the retina as the film develops and becomes more dense. It can cause wrinkles in the retina, pulling it up and stretching it. This can cause leakage from the blood vessels and further swelling.
Another name for epiretinal membrane is cellophane retinopathy. You can understand this since when we look inside the eye, the membrane can have a little bit of a sheen like cellophane. ERMs are also called macular pucker because they can cause the macula in the center of the retina to pucker and become curved and wrinkled.

If you have any questions about epiretinal membranes, please post and we will be happy to answer them. If there is enough interest, maybe we can have a retinal specialist join us to explain in more detail than I can. Hopefully we will see you again soon next time on A State of Sight.