- May occur in young people, but most commonly in elderly over the
age of 50.
- May occur in association with many ocular diseases or conditions
such as posterior vitreous detachment, retinal tear or detachment,
inflammatory diseases, retinopexy, trauma, intraocular surgery, scleral
buckilng, diabetes mellitus and retinal vascular occlusive diseases
or can be idiopathic.
- Clinical features:
- Symptoms:
- Maybe asymptomatic
- Mild distortion or decrease in vision
- Metamorphopsia, diplopia, central photopsia and macropsia.
- Loss of central vision
- Signs:
- Subtle membrane (cellophane maculopahty) appears as an irregular
light reflex with indistinct border when viewed with indirect
ophthalmoscopy
- Prominent sign of epiretinal membrane: fine, superficial
radiating folds of the inner retinal layers extending outward
from the margin of contractile membrane
- A large contracted membrane may cause dragging and/or increasing
tortuosity of the underlying paramacular retinal vessels
- May present as a macular "pseudohole"
when the altered foveal red reflex that appears darker is
surrounded by a relatively pale contracted membrane
- May occasionally be complicated by macular hole, macular edema,
hemorrhage, foveal cyst or choroidal neovascularization.
- Fluorescein angiography demonstrates:
- Various degree of retinal vessels tortuosity
- Dye leakage when macular edema is present
- Helpful in determining pseudohole from macular hole, where macular
hole invariably has a central window defect
- Management:
- Observation if the visual acuity is 20/50 or better, or the membrane
remains stable or unchanged.
- When visual acuity is decreased and significantly interfering
with the patient's daily activities, surgical intervention is usually
indicated.
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