Abstract
Purpose
To report the clinical features of the eye of young patients with an idiopathic macular epiretinal membrane (ERM), and the visual outcomes after the surgical removal of the ERM.
Methods
A retrospective review of the medical records of eight young patients (age, 23–39 years; mean, 32.5 years) with an idiopathic macular ERM was performed. The patients underwent vitrectomy and removal of the ERM with peeling of the internal limiting membrane (ILM). The pre- and postoperative visual acuity and intra- and postoperative complications were investigated.
Results
Ophthalmoscopically, the ERMs in seven eyes were white, opaque, and dense, while one was grayish-white and less dense. A posterior vitreous detachment was not present and the ERM adhered strongly to the underlying retina in all eight eyes. The mean best-corrected visual acuity (BCVA) preoperatively was 20/140 (Snellen; range: 20/250–20/63), and the BCVA improved significantly to 20/30 (range: 20/40–20/20) postoperatively with an average follow-up of 14.6 months (range: 6–42 months; Wilcoxon sign-rank test, P<0.001). An improvement of >7 lines was observed in seven of eight eyes. A recurrence of an ERM without involving the macula was detected in one eye (12.5%).
Conclusions
The clinical features of the ERMs in young patients are different from those in elderly patients, eg, thicker, more adherent to the retina, and still attached to the vitreous. Vitrectomy and removal of ERM with ILM peeling are effective and safe surgical procedures. Removal of the ILM may minimize the recurrence of an ERM.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Appiah AP, Hirose T, Kado M . A review of 324 cases of idiopathic premacular gliosis. Am J Ophthalmol 1988; 106: 533–535.
Pesin SR, Olk RJ, Grand MG, Boniuk I, Arribas NP, Thomas MA et al. Vitrectomy for premacular fibroplasias. Prognostic factors, long-term follow up, and time course of visual improvement. Ophthalmology 1991; 98: 1109–1114.
Margherio RR, Cox Jr MS, Trese MS, Murphy PL, Johnson J, Minor LA . Removal of epiretinal membrane. Ophthalmology 1985; 92: 1075–1083.
Grewing R, Mester U . Results of surgery for epiretinal membranes and their recurrences. Br J Ophthalmol 1996; 80: 323–326.
Sidd RJ, Fine SL, Owens SL, Patz A . Idiopathic preretinal gliosis. Am J Ophthalmol 1982; 94: 44.
Barr CC, Michels RG . Idiopathic nonvascularized epiretinal membranes in young patients: report of six cases. Ann Ophthalmol 1982; 14: 335–341.
Meyer CH, Rodrigues EB, Mennel S, Schmidt JC, Kroll P . Spontaneous separation of epiretinal membrane in young subjects: personal observations and review of the literature. Graefes Arch Clin Exp Ophthalmol 2004; 242: 977–985.
Mulligan TG, Daily MJ . Spontaneous peeling of an idiopathic epiretinal membrane in a young patient. Arch Ophthalmol 1992; 110: 1367–1368.
Desatnik H, Treister G, Moisseiev J . Spontaneous separation of an idiopathic macular pucker in a young girl. Am J Ophthalmol 1999; 127: 729–731.
Kimmel AS, Weingeist TA, Blodi CF . Idiopathic premacular gliosis in children and adolescents. Am J Ophthalmol 1989; 108: 578–581.
Banach MJ, Hassan TS, Cox MS, Margherio RR, Williams GA, Garretson BR et al. Clinical course and surgical treatment of macular epiretinal membranes in young subjects. Ophthalmology 2001; 108: 23–26.
Smiddy WE, Michels RG, Gilbert HD, Green WR . Clinicopathologic study of idiopathic macular pucker in children and young adults. Retina 1992; 12: 232–236.
Smiddy WE, Maguire AM, Green WR, Michels RG, de la Cruz Z, Enger C et al. Idiopathic epiretinal membranes. Ultrastructural characteristics and clinicopathologic correlation. Ophthalmology 1989; 96: 811–820.
Benhamou N, Massin P, Spolaore R, Paques M, Gaudric A . Surgical management of epiretinal membrane in young patients. Am J Ophthalmol 2002; 133: 358–364.
Kwok AK, Li WW, Pang CP, Lai TY, Yam GH, Chan NR et al. Indocyanine green staining and removal of internal limiting membrane in macular hole surgery: histology and outcome. Am J Ophthalmol 2001; 132: 178–183.
Brooks HL . Macular hole surgery with and without internal limiting membrane peeling. Ophthalmology 2000; 107: 1939–1948.
Park DW, Dugel PU, Garda J, Sipperley JO, Thach A, Sneed SR et al. Macular pucker removal with and without internal limiting membrane peeling: pilot study. Ophthalmology 2003; 110: 62–64.
Kwok AK, Lai TY, Yuen KS . Epiretinal membrane surgery with or without internal limiting membrane peeling. Clin Experiment Ophthalmol 2003; 31: 470–475.
Haritoglou C, Eibl K, Schaumberger M, Mueller AJ, Priglinger S, Alge C et al. Functional outcome after trypan blue-assisted vitrectomy for macular pucker: a prospective, randomized, comparative trial. Am J Ophthalmol 2004; 138: 1–5.
Bardak Y, Cekic O, Tig SU . Comparison of ICG-assisted ILM peeling and triamcinolone-assisted posterior vitreous removal in diffuse diabetic macular edema. Eye 2006; 20: 1357–1359.
Ikagawa H, Yoneda M, Iwaki M, Isogai Z, Tsujii K, Yamazaki R et al. Chemical toxicity of indocyanine green damages retinal pigment epithelium. Invest Ophthalmol Vis Sci 2005; 46: 2531–2539.
Cekic O, Morimoto T, Ohji M, Sawa M, Hasegawa T, Sakaguchi H et al. Nonaxoplasmic transfer of indocyanine green into the optic nerve after intravitreal application. Retina 2004; 24: 412–415.
Uemura A, Kanda S, Sakamoto Y, Kita H . Visual field defects after uneventful vitrectomy for epiretinal membrane with indocyanine green-assisted internal limiting membrane peeling. Am J Ophthalmol 2003; 136: 252–257.
Ando F, Yasui O, Hirose H, Ohba N . Optic nerve atrophy after vitrectomy with indocyanine green-assisted internal limiting membrane peeling in diffuse diabetic macular edema. Adverse effect of ICG-assisted ILM peeling. Graefes Arch Clin Exp Ophthalmol 2004; 242: 995–999.
Kusaka S, Oshita T, Ohji M, Tano Y . Reduction of the toxic effect of indocyanine green on retinal pigment epithelium during macular hole surgery. Retina 2003; 23: 733–734.
Kwok AK, Lai TY, Li WW, Yew DT, Wong VW . Trypan blue- and indocyanine green-assisted epiretinal membrane surgery: clinical and histopathological studies. Eye 2004; 18: 882–888.
Kishi S, Shimizu K . Oval defect in detached posterior hyaloid membrane in idiopathic preretinal macular fibrosis. Am J Ophthalmol 1994; 118: 451–456.
Heilskiov TW, Massicotte SJ, Folk JC . Epiretinal macular membranes in eyes with attached posterior cortical vitreous. Retina 1996; 16: 279–284.
Kakehashi A, Kado M, Akiba J, Hirokawa H . Variations of posterior vitreous detachment. Br J Ophthalmol 1997; 81: 527–532.
Thompson JT . The role of patient age and intraocular gas use in cataract progression after vitrectomy for macular holes and epiretinal membranes. Am J Ophthalmol 2004; 137: 250–257.
Cheng L, Azen SP, El-Bradey MH, Toyoguchi M, Chaidhawangul S, Rivero ME et al. Duration of vitrectomy and postoperative cataract in the vitrectomy for macular hole study. Am J Ophthalmol 2001; 132: 881–887.
Acknowledgements
This work was supported by a grant from the National Natural Science Foundation (No. 60671005), China.
Author information
Authors and Affiliations
Corresponding author
Additional information
Proprietary interests: none
Rights and permissions
About this article
Cite this article
Fang, X., Chen, Z., Weng, Y. et al. Surgical outcome after removal of idiopathic macular epiretinal membrane in young patients. Eye 22, 1430–1435 (2008). https://doi.org/10.1038/sj.eye.6702963
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.eye.6702963
Keywords
This article is cited by
-
Clinical features of idiopathic epiretinal membrane in children and the factors influencing postoperative visual acuity
Graefe's Archive for Clinical and Experimental Ophthalmology (2023)
-
Juvenile idiopathische epiretinale Membran
Der Ophthalmologe (2016)
-
Optical coherence tomographic characteristics and surgical outcome of eyes with myopic foveoschisis
Eye (2009)
-
Anatomical and visual outcome after vitrectomy with triamcinolone acedonide-assisted epiretinal membrane removal in highly myopic eyes with retinal detachment due to macular hole
Eye (2009)


