Epiretinal – Epimacular Membrane
What is macula?
The retina is the photosensitive layer of tissue located at the back of the eye. A small area (approximately three millimeters in diameter) in the center of the retina, called the macula is responsible for clear vision and color perception.
What is an epimacular membrane?
The macula normally shows an oval shaped, reduced thickness in its center. The macular membrane causes traction, flattening, swelling (edema) and deformation of the macular resulting in impaired vision.
What are the symptoms of the epiretinal membrane?
Vision becomes blurred and distorted, just as a photo appears when the film is wrinkled. Straight lines, such as the door border or telephone cables, are wavy.
The visual disturbance can be mild without being noticed, moderate or very pronounced.
What causes the macular membrane?
The cause of the macular membrane in most cases is unknown. A thin, transparent membrane develops on the macula. It then contracts and shrinks, causing the macular to wrinkle. The most common form of the macular membrane is idiopathic.
Ophthalmological diseases associated with the macular membrane are as follows:
- posterior detachment of the vitreous body
- retinal detachment or tear
- inflammation of the eye
- severe eye injury
- vascular problems of the retina
- The macular membrane is usually not associated with systemic diseases.
How is it diagnosed?
Through fundoscopy as part of a clinical examination. The most appropriate imaging method is the OCT (optical coherence tomography) examination, in which thousands of high-resolution retinal scans take place within seconds to help assess the extent and progress or stability of the lesion.
Has every epimacular membrane to be treated?
Treatment is not necessary if the symptoms are mild. Vision is not improved with drops, drugs or laser. If necessary (reduction of visual acuity, distortion) vitrectomy with removal of the membrane is the only therapeutic approach. In this operation, which is performed under local anesthesia and lasts about 30 minutes, the membrane is removed with very thin tools less than 0.4 mm in diameter. After removal of the membrane, the macula gradually, partially flattens and at the same time the vision usually gradually improves. When the membrane is long-lasting and the preoperative visual acuity is very low, vision may not return to normal levels. Cataract (blurring of the eye lens) may occur later. Complications are very rare, but may include:
- retinal detachment
- reappearance of the membrane
Surgery is not necessary in all those who have a macular membrane. Many patients with slight blurred vision may not be bothered enough and may not need surgery. In advanced forms, where there is macular deformity and impaired vision is annoying for the patient, then surgery is indicated.
Temporarily poor vision. Vision in the first few days may be decreased.
Mild pain or discomfort. The eye is slightly irritated after surgery.
Contact the doctor immediately if:
- There’s intense pain.
- Vision worsens.
At the end of the operation usually the eye is covered just for the same day with a bandage. The next day the bandage is removed in the infirmary.
Medication: instillation of antibiotic and steroid drops.
Follow up: one day, one week and one month after surgery.
Avoidance is required in the first few weeks:
- eye rubbing
- intensive exercise
- eye makeup
Travel: flight by aircraft and access to any altitude is permitted.
Driving: allowed even on the first postoperative day if vision is suitable
Work: if it is an office job it is allowed from the first postoperative day.
Possible complications: retinal detachment, infection, bleeding, cataracts.
Cataract will almost certainly occur after months if cataract surgery has not already been performed.
Retinal detachment occurs in 1 to 2 in 100 people and requires surgical treatment.
Hemorrhage is very rare, as is infection, which occurs in about 1 in 5000 patients.
Success rate of the operation: the most important factor is the duration and the size of the damage caused by the membrane.
Probability of the appearance of a macular hole in the other eye: about 30% without this implying surgical treatment anyway
Why are regular eye tests important to everyone?
Diseases of the eye can occur at any age. Many eye diseases do not cause symptoms until the disease has caused damage. Because most conditions that cause blindness can be prevented if they are diagnosed and treated in a timely manner, regular examination by an ophthalmologist is very important.