You Said I Have A Wrinkly Retina?
There are numerous eye diseases and conditions that can impact the ability of the retina to function appropriately. One condition that is commonly seen in our clinic is a “wrinkly retina,” also known as an Epiretinal Membrane (ERM). Other names for ERM include cellophane maculopathy and macular pucker. ERMs are known to occur in approximately one-third of the population over 60 years of age.
To understand an ERM, first we need to review a few ocular basics. The retina is the inner lining in the back of the eye that contains all the neuro-sensory cells that detect light. This layer sends signals to the brain which allows us to see. This “wrinkling of the tissue” is actually a film or membrane that has formed over the retina. The membrane is formed from cells that have risen to the surface through microscopic cracks. Over time, this membrane will start to contract and pull away from the retina causing it to “pucker” or “wrinkle,” which then distorts vision
ERMs can be associated with many ocular conditions but most commonly occur alongside posterior vitreal detachments (PVD). A PVD is a normally occurring detachment of the vitreous, the jelly-like substance in the back of the eye, from the retina. Over 80% of ERMs are associated with PVDs. The pulling of the vitreous from the retina creates micro-fractures in the internal limiting membrane (ILM), the top-most layer of the retina, which glial cells move through creating an ERM.
Will this make your eyes look wrinkled? The answer is no. Epiretinal membranes are not visible from the outside of the eye. They are typically detected incidentally during routine eye exams. This membrane will appear as a shiny film on the retinal surface. Imaging tools, like OCT, aid in diagnosis by giving an in depth view of the retina. This provides the ability to view the film and measure the retinal thickness for close monitoring. Patients will also be asked to monitor their vision at home using a home Amsler Grid. The Amsler Grid will allow the patient to visualize distortion within their vision between visits at the eye doctor.
ERMs typically have an initial period of growth before remaining stable. Thankfully, the majority of cases have no or minimal effect on the vision! Close monitoring over time is imperative. If there is progression and/or vision is compromised, surgery may be needed to prevent further changes from occurring. Surgical options can gently peel the membrane away, but may not fully restore vision.
A wrinkly retina can seem concerning if mentioned at your eye exam, but have no fear! Our team at FPEC is here to ensure you are being treated and monitored appropriately to keep you seeing your best! If you notice any sudden changes in vision, call to schedule a dilated examination as soon as possible.