Macular Epiretinal Membranes
Epiretinal membranes (ERMs) have a variable clinical course. There are generally 2 indications for surgery: (1) reduced visual acuity or (2) distortion causing dysfunction of binocularity. In general, epiretinal membrane peel (Video 20-1) is advised if visual acuity is reduced to 20/40–20/60 or worse. Separately, dysfunction of binocularity that involves difficulty with fusion of 1 distorted and 1 normal-vision image is an indication for surgery, even if the patient’s visual acuity is still good (Fig 20-1).
Vitrectomy for epiretinal membrane peel.
Courtesy of Colin A. McCannel, MD.
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After surgery, approximately two-thirds of patients achieve an improvement in visual acuity of 2 or more lines. Maximal improvement may take up to 6–12 months (Fig 20-2). Although improvement in patients with metamorphopsia is nearly universal, complete resolution usually does not occur.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.