Macular Pucker

Macular Pucker (Epiretinal Membrane)

A macular pucker is a transparent membrane that grows on the front surface of the retina in the macula. A macular pucker can also be referred to as an epiretinal membrane (ERM), cellophane maculopathy, or a “wrinkle” on the retina.

Causes

A macular pucker typically forms following the development of a vitreous detachment. With age, the vitreous gel changes in consistency and position relative to the retina. When the vitreous separates from the retina, it may leave behind debris on the surface of the retina which is believed to contribute to macular pucker formation. Alternate causes of macular pucker formation may include trauma, intraocular inflammation, and prior eye surgery. A macular pucker is often detected incidentally on routine dilated examinations.

Symptoms

Symptoms may be nonexistent in a mild macular pucker. A more significant macular pucker, however, can alter the underlying retinal architecture and thereby impact vision; typical visual symptoms may include generalized reduction in visual acuity, distortion, and/or difficulty with near vision. Typically, visual symptoms are taken into account when determining if observation or surgical management in appropriate.

Diagnosis and Management

Diagnosis of macular pucker is typically made using non-invasive imaging called ocular coherence tomography (OCT). OCT is similarly used to monitor a macular pucker over time.  If a macular pucker grows or progresses to alter the retinal anatomy, it may be necessary for the macular pucker to be surgically removed via vitrectomy with membrane peel.

Learn more about epiretinal membranes.