Digital Image - Little To See

OCT - Epiretinal Membrane

About Epiretinal Membranes
The pictures above are of a Moderate Left Epiretinal Membrane (ERM):

  • Present in approximately 1 in 15 adults over the age of 50 to some degree.
  • May cause blurred or distorted vision. However; it is not uncommon for patients to be completely symptom free.
  • Most ERM’s do not need any treatment.
  • They are thought to be an abnormal adhesion between the outer layer of the vitreous and the macula.
  • In most cases, the cause is unknown (idiopathic).
  • The list of potential causes is extensive.
  • Some potential causes include retinal tears, vascular occlusions, uveitis, and previous injuries.
  • ERM’s tend to remain stable or progress slowly.
  • We recommend a 6 monthly check initially until we are certain that the ERM is not changing.
  • Approximately 1% will come away spontaneously.
How is an ERM Diagnosed?
The gold standard in diagnostic tools for an ERM is the OCT (click here for more on OCT’s). As can be seen in the example above the OCT scan gives us an incredible amount of additional information. Far more than we get from a standard digital photograph.

The reason we can see more is that the OCT provides a scan through the retina. The scan clearly shows which layers, at the back of the eye, are being affected by the ERM.

Your eye care professional may also opt to dilate your pupils and view the retina with a variety different instruments.

Seeing your Ophthalmologist
We will refer patients to see the Ophthalmologist (Eye Specialist) who have a vision level of 6/9 or worse or who report seeing distortions.

I have an extra rule that I apply to my patient care. That is; if I find the patient is developing cataracts I will refer a central ERM, such as this one, sooner. The reason for that is I want to give the Ophthalmologist a good look at the back of the patient’s eyes before the cataract obscures the view.

In the scans above the ERM is affecting the most important part of the eye (the macular). So here again I tend to be overly cautious and recommend to the patient that they see the Ophthalmologist sooner. I want to be certain there are no other issues hidden away.

All patients are placed on a 6-month review so we can monitor the ERM for change.

Like so many other eye diseases, any loss of vision occurs in tiny, tiny amounts over very long periods of time (months or even years). The changes are so small and take so long, that most people do not realise they have a problem until it is too late. Early detection is the key. Remember, advances in medicine never stop so never be afraid to ask: “Are there any new treatments for ERM?”