University of Iowa Health Care

Ophthalmology and Visual Sciences

Epiretinal membrane

Contributor: Eric Chin, MD

Photographer: Randy Verdick, FOPS


A 66-year-old pseudophakic female presented with worsening blurry vision and metamorphopsia, right eye more than left eye. She also complained of monocular diplopia in the right eye. She denied pain or irritation.

Her visual acuity was 20/60 in the right eye and 20/50-2 in the left eye, with no improvement with pinholes in either eye.

(Click on any image below for higher resolution)

1. Right eye: diffuse dense epiretinal membrane/macular pucker

Epiretinal Membrane, right eye

2. Left eye: trace epiretinal membrane

Unaffected eye

3 Optical coherence tomography of the right eye reveals an epiretinal membrane and diffuse retinal thickening of the macula.

OCT, right eye

4. Optical coherence tomography of the left eye reveals trace retinal thickening and epiretinal membrane

OCT, right eye

Epiretinal Membranes

  • An epiretinal membrane (ERM) is a semi-translucent, avascular, fibrocellular membrane on the inner retinal surface along the internal limiting membrane of the retina.
  • ERMs may be idiopathic, or secondary to a variety of conditions such as retinal vascular occlusions, uveitis, trauma, intraocular surgery, and retinal breaks.
  • Contracture of ERMs produces distortion and wrinkling of the inner surface of the retina. It is also called “cellophane maculopathy” or “pre-retinal macular fibrosis” when mild; “surface wrinkling retinopathy” or “retinal striae” when moderate; or “macular pucker” when severe.

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last updated: 08/15/2013
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