Most common causes of pediatric epiretinal membrane are trauma and uveitis

To describe the incidence and clinical characteristics of this condition in children, researchers retrospectively reviewed the records of all patients aged 18 and younger diagnosed with an epiretinal membrane (ERM) at a single site during a 30-year period.

They found ERMs are rare in children, with an incidence of 0.54 per 100,000 patients. Trauma was the most common cause, occurring in 39 percent of patients; uveitis was found in 20 percent and no cause in 30 percent of patients.

The cellophane macular reflex (CMR) type of ERM, often considered the most common and benign form, was found in only 25 percent of patients. The authors suggest that its relatively benign symptoms may make it less likely to be noticed.

Mean age at the time of diagnosis among the study population was 12.4 years and ranged from four months to 18 years. Most were boys (70 percent). In half of patients, the presenting visual acuity in the affected eye was 20/60 or less, and 23 percent of them displayed strabismus.

Patients treated surgically generally have a favorable outcome. Eight of the 44 patients underwent pars plana vitrectomy with membrane peel and at least five of them experienced an improvement in visual acuity postoperatively. One of the patients subsequently developed a nuclear sclerotic cataract and another a recurrent ERM sufficient to require a second peeling.