macular pucker; epiretinal membrane (ERM); preretinal membrane; cellophane maculopathy; retina wrinkle; surface wrinkling retinopathy; premacular fibrosis; internal limiting membrane disease

Introduction

scar tissue that has formed on the macula retinae

Etiology

• vitreous detachment
• retinal detachment
• uveitis
• diabetic retinopathy
• eye trauma

Pathology

• when vitreous pulls away from the retina, microscopic damage to the retina's surface may occur
• the retina begins a healing process to the damaged area & forms scar tissue, or an epiretinal membrane, firmly attached to the retina surface
• when the scar tissue contracts, it causes the retina to wrinkle, or pucker, usually without any effect on central vision
• if the scar tissue has formed over the macula, central vision becomes blurred & distorted Clinical manifstations:
• usually affects one eye; other eye may be affected later
• blurry vision
• distorted central vision
• difficulty in seeing fine detail & reading small print
• blind spot
• severe vision loss is uncommon

Differential diagnosis

macular hole

Management

• usually requires no treatment
• usually does not affect activities of daily life, such as reading & driving
• surgery: vitrectomy rarely required
  • macular pucker may rarely grow back

Prognosis:

• for most people, vision remains stable & does not get progressively worse.
• sometimes the scar tissue separates from the retina, & the macular pucker resolves

More general terms

• retinal disease