Surgical Retina

Epiretinal Membrane

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  • A common acquired macular disease
  • A fibro-cellular layer develops over the macula
  • PVD leads to vitreomacular traction and disruption of the ILM. This allows cellular migration and proliferation
  • Contraction of the ERM can leads to macular pucker
  • Can lead to reduced vision/distortion

Classification

  • Idiopathic: age-related
  • Secondary
    • Vascular: diabetic retinopathy, CRVO
    • Inflammatory: posterior uveitis
    • Traumatic
    • Iatrogenic: retinal surgery, laser, cryotherapy

Management

  • Depends on degree of symptoms and patient requirements

  • Supporting surgery (vitrectomy and ILM peeling)

    • Visual loss <6 months
    • VA < 20/60
    • No CMO
  • 50-75% will have improved vision post-operatively although it rarely returns to pre-existing levels

Complications

  • ERM recurrence
  • Cataract
  • Retinal breaks/RD
  • Vitreous haemorrhage
  • Endophthalmitis

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Vitreoretinal Interface And Macular Hole