Epiretinal membrane is also known as a macular pucker, epimacular proliferation, and cellophane maculopathy. This entity causes wrinkling in the macular area, which is when the clear membrane that lies on the retinal surface contracts. The patient will generally present with blurred vision, double vision (noticeable even with one eye covered), vision where straight lines appear bent or wavy. The early stage of epiretinal membrane does not affect the vision with the exception of glittery light reflex in the macular area. The later stage of the disease shows significant wrinkling and distortion of the retina, special photography may show swelling, bleeding and cotton-wool spots with significant vision loss.
The cells involved in epiretinal membranes are predominantly fibrous astrocytes and Muller cells. Glial cells of retinal origin proliferate through defects in the internal limiting membrane. The breaks usually are associated with vitreous separation.
Treatment in some cases includes vitrectomy and membrane peeling if the patient’s quality of life is being affected. An Amsler grid should be utilized daily for any visual decline, however, the patient should be aware that vision usually stabilizes after a membrane growth period of a few weeks to a few months. Spontaneous avulsion of epiretinal membranes can occur with subsequent vitreous separation.