Retina · Retinal surgery
An epiretinal membrane is a thin film of tissue that forms on the surface of the retina, at the macula. As it contracts, it puckers the retina and distorts vision. Depending on the degree of disturbance, management may involve monitoring or surgery.
An epiretinal membrane is a thin sheet of tissue that develops on the surface of the retina, at the macula, the centre of vision. As it gradually contracts, it puckers the underlying retina, rather like cling film that crumples, distorting the perceived image.
It most often progresses slowly. Not all membranes require surgery: the decision depends on the degree of visual disturbance and its progression over time.
An epiretinal membrane affects central vision, without pain. OCT allows it to be visualised and its impact precisely monitored.
Epiretinal membranes are most often related to ageing of the vitreous. They may also follow other conditions:
The degree of disturbance varies according to the thickness of the membrane and its impact:
OCT (optical coherence tomography) is the reference examination: it visualises the membrane, measures its impact on the macula, and allows progression to be monitored, without contact or discomfort. This is where Dr Gattoussi's expertise in retinal imaging is particularly valuable.
Not all membranes are operated on. The decision depends on the degree of visual disturbance, its impact on vision, and its progression over time.
When the membrane is thin and causes little disturbance, regular OCT monitoring alone may suffice, without intervention.
When the disturbance is significant or worsening, a surgical procedure may be offered to remove the membrane (peeling) by vitrectomy.
When surgery is chosen, the procedure aims to carefully remove the membrane from the surface of the retina. [TO BE VALIDATED BY THE PRACTITIONER: technique]
Measurement of impact and discussion of the indication.
The vitreous is removed through micro-incisions to access the macula.
The membrane is carefully removed from the surface of the retina.
Monitoring of recovery, which is gradual.
No. Membranes causing little disturbance can simply be monitored. Surgery is offered when the disturbance is significant or progressive.
Recovery depends on how long the membrane has been present and its impact. It is gradual and assessed on a case-by-case basis, with no guarantee of outcome.
Recurrence is possible but uncommon. This is discussed during consultation and follow-up.
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