Vitreous & Retina

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Macular Diseases
OCT study of a macular pucker demonstrating an elevated fovea off the pigment epithelium and a dense epiretinal membrane.
Macular Pucker

  • The formation of thick, coarse, dense membrane which causes marked distortion of the macula that may sometimes elevates the fovea off the pigment epithelium. (puckering the macula)
  • Clinical features:
    • Symptoms:
      • Markedly decreased vision or loss of central vision
      • Metamorphopsia
      • Diplopia
      • Central photopsia or macropsia
    • Signs:
      • Thick, opaque membrane may obscure the visibility of the macula
      • Foveal ectopia
      • Commonly causes dragging of the paramacular retinal vessels
  • Chronic cases may be complicated with retinal pigment epithelium changes, retinal vascular leakage, macular hole, macular edema, hemorrhage, foveal cyst or choroidal neovascularization.
  • Fluorescein angiogram demonstrates:
    • Dragged perifoveal vessel
    • Dye leakage
  • Management: vitreoretinal surgery should be considered when significant visual reduction (BCVA of < 20/50) has occurred.

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