I have an epiretinal membrane. What do I need to know?;

We can liken our eye to a camera, where the eye can be used as a camera. retina is the film on which the image of the picture we observe is recorded.

The area responsible for our central vision and for recognising faces is called macula and is located in center of the retina.

Η epiretinal membrane is a translucent membrane of fibrous tissue that is formed on the αμφιβληστροειδή. It is essentially scar tissue, which grows around and on top of the ochre.

Η maturation of the membrane causes contraction and retraction leading to distortion of the image in the αμφιβληστροειδή, resulting in the ochre not working properly and patients have problems with demanding tasks such as reading.

In advanced stages, vision is reduced, especially when the membrane is in the centre of the Lachrymose.

Usually the epiretinal membrane is seen in people who have no previous eye history, but are over 50 years of age. Its incidence increases with age, with 20% of the population showing epiretinal membrane at around 70 years of age.

The vitreous body or vitreous is located in front of the retina and fills the eyeball, giving it shape.

It consists of a gel which after 50 years due to relaxation starts to liquefy.

These changes in the vitreous allow cells from the retina and other parts of the eye to circulate in the gel and eventually settle in the macula, where they form a membrane.

Sometimes the epiretinal membrane may be caused secondarily by a previous eye problem such as Rupture ή retinal detachment, trauma, inflammation etc.

Patients in the early stages of the disease do not report symptoms because the decline in vision progresses slowly. However, studies show that 10-25% of patients lose 2 lines within 2 years.

Symptoms of epiretinal membrane

Usual symptoms of retinal membrane symptoms are also distortions of straight lines and double vision in one eye.

Despite the loss of central vision, however, the epiretinal membrane does not cause total blindness, as peripheral vision appears to remain intact.

The diagnosis of epiretinal membrane

The clinical diagnosis of epiretinal membrane disease is carried out by dowsing in the slit lamp. A decrease in visual acuity, as well as the sensation that the numbers in the optotype or the lines in the Amsler chart are distorted (Figure 2b) can give us a qualitative estimate of the extent of the deformity. In addition, diagnostic fluorescein angiography (taking photographs via dye injection) can accurately reveal the extent of damage to the fundus of the eye.

Optical coherence tomography (OCT) as an imaging modality is important for confirming the disease, as it provides high-resolution three-dimensional layered images in fractions of a second.

It can detect thin epiretinal membranes and is beneficial both in the prognosis of the disease and in the management of treatment as the evaluation of each scan can help the doctor in the best approach to membrane removal.

Treatment of the epiretinal membrane

Η treatment of the retinal membrane is decided when the symptoms of deformity become severe and visual acuity decreases to about 6/10. The removal of the membrane is performed surgically after a vitrectomy, where the vitreous gel is replaced by saline inside the eye.

The reduction and elimination of central visual distortions depends on many factors such as the patient's history, preoperative visual acuity and the duration of the disorder. In idiopathic cases postoperatively there is an improvement of ≥2 lines in the numerical table. In most patients, vision improves in the first 3-6 postoperative months, and some may show improvement after 1 year. In any case, an important predictor of final visual acuity is the preoperative measurement.

According to the international literature >75% of patients show improvement in visual acuity postoperatively, mainly in idiopathic cases. Only 5% have seen a decrease in vision in membranes that develop secondarily.

The operating room should be governed by strict hygiene rules to avoid the risk of intraocular infection. The normal progression of cataract is likely to be accelerated postoperatively and a funduscopy should be performed during postoperative visits to avoid the risk of retinal detachment.