Pathophysiology, Classification, Clinical Diagnosis and Treatment of Primary Epiretinal Membrane

Epiretinal membrane (ERM), also known as macular pucker, premacular fibroplasia, premacular gliosis or cellophane maculopathy is a common vitreoretinal interface pathology that can result in mild to moderate visual impairment with impact on quality of life. ERM can be classified as primary “idiopathic” or secondary. Most ERMs occur in individuals older than 50 years, and the prevalence of ERM increases as age increases. The pathological mechanisms are not entirely known, however the posterior vitreous detachment is thought to be key. Diagnosis and classification of ERM is based on clinical examination findings. However, high resolution spectral domain-optic coherence tomographies (SD-OCTs) have proven to be more sensitive than clinical examination for the diagnosis of numerous disorders of the vitreomacular interface, including ERM. SD-OCTs enable pre- and postoperative comparison of macular structures in a non-invasive examination. In treatment, surgical intervention entails pars plana vitrectomy with ERM removal with or without internal limiting membrane (ILM) removal. A good visual recovery was present in most patients after surgery.