 Central Florida Retina Institute, Specializing
in diseases and surgery of the retina, macula, and vitreous,
 877-245-2020
Retina FAQs | Glossary
of Ophthalmologic Terms | Description
of a Retina | Diabetic
Retinopathy | Epiretinal
Membranes | Flashers &
Floaters | Macular Degeneration
| Macular Holes | Retinal
Detachment | Retinopathy
Of Prematurity | Clinical Trials
Q: What is an Epiretinal membrane?
A: A thin layer of tissue on
the front surface of the macula which is the center of the retina
and the region responsible for acute vision.
Q: What are the symptoms?
A: They are:
• decreased straight ahead vision (central vision), and
• distortion of central vision.
Q: Can Epiretinal membranes cause total
blindness?
A: No, only loss and distortion
of central vision.
Q: How common are Epiretinal membranes?
A: Epiretinal membranes are
moderately common.
Q: How fast do Epiretinal membranes progress?
A: Some doctors believe that
Epiretinal membranes progress over many months or even years
and gradually worsen vision over this time.
Our doctors have shown that
most of the progression takes about one month and then the vision
remains stable or decreases slightly.
Q: What are the causes of Epiretinal membranes?
A: Most Epiretinal membranes
apparently develop due to posterior vitreous separation. Epiretinal
membranes formed by this process as termed "idiopathic"
which means "unknown cause".
Freezing treatment (cryo) or
laser treatment used to treat retinal tears and breaks can apparently
contribute to the formation of Epiretinal membranes, although
the retinal tears or breaks being treated with these techniques
can also cause the formation of Epiretinal membranes without
treatment.
Inflammatory eye diseases can
cause Epiretinal membranes.
Approximately 2.5% of otherwise
successful retinal detachment surgeries are followed by the development
of Epiretinal membranes.
Q: Does hardening of the arteries cause
Epiretinal membranes?
A: No, circulation problems
have not been shown to have any relation to Epiretinal membranes.
Q: Are eye strain, nutrition, general health,
smoking or emotional stress related to Epiretinal membranes?
A: No, there is no known relationship
between Epiretinal membranes and any of these problems.
Q: If one eye develops an Epiretinal membrane,
will the other eye develop one?
A: Usually not; most patients
develop membranes in one eye only.
Q: What is the treatment for Epiretinal
membranes?
A: Vitrectomy surgery and peeling
of the membrane (thin tissue layer) from the retinal surface
is required to treat Epiretinal membranes.
Dr. Charles developed forceps
membrane peeling techniques in the early 1980s. This technique
has been improved by using an inside out, circular motion and
special forceps that conform to the retina surface. Forceps membrane
peeling, developed by Dr. Steve Charles, is more precise than
the FILMS method.
Q: Is ICG dye needed for this type of surgery?
A: ICG dye is not recommended
for two reasons:
• The dye is not needed to see the Epiretinal membrane.
• Toxicity of the dye has been reported.
Q: If surgery is not performed, will
the Epiretinal membrane progress?
A: Since the condition usually
stabilizes in one or two months with minimal subsequent progession,
patients do not need surgery to prevent progression, but only
to improve vision.
Q: What are the criteria for surgery as
treatment for Epiretinal membranes?
A: Noticeable distortion of
central vision is the most important criterion.
If the doctor makes the patient
aware of the problem but the patient does not notice any visual
difficulties, surgery is not required.
If the problem affects the patient's
ability to work, drive, perform certain recreational activities,
read, see medicine labels, or other critical activities, surgery
should be considered.
Experienced surgeons operate
on patients with 20/40 vision or worse, if the above criteria
are met.
The doctor must make certain
that there is no other cause of visual loss such as macular degeneration
or damage, previous prolonged retinal detachment, or circulatory
problems.
Q: Is there a non-surgical treatment for
Epiretinal membranes?
A: No, there is no medicine,
eye drop, vitamin, herb, or diet that is beneficial to Epiretinal
membrane patients.
Q: Is there a laser treatment for Epiretinal
membranes?
A: No, only surgery can remove
Epiretinal membranes.
Q: Do Epiretinal membranes ever disappear
without surgery?
A: No, there is no credible
evidence for spontaneous disappearance of Epiretinal membranes.
Q: What drops should be used after vitreous
surgery for Epiretinal membranes?
A: Most doctors use steroid
drops, an antibiotic drop, and some use a dilating drop for a
few days after surgery.
Q: How long does surgery for Epiretinal
membranes take?
A: The procedures usually take
less than thirty minutes.
Q: Is the surgery performed on an inpatient
or outpatient basis?
A: The surgery is performed
on an outpatient basis in all cases unless there is a medical
reason to stay overnight in the hospital.
Q: What is the success rate of surgery?
A: Visual improvement occurs
in over 95% of cases.
The retina is nerve tissue and
can require months to fully regain its function. Epiretinal membranes
cause distortion and wrinkling of the retina which takes time
to resolve after removal of the membrane.
There are no medications which
can speed this process at present.
Q: Can complications occur due to the surgery?
A: Yes, there is a significant
incidence of progression of pre-existing cataract after vitrectomy
surgery. Some doctors believe that patients with an absolutely
clear lens develop cataracts as a result of vitreous surgery,
but this has not been proven. The vast majority of patients requiring
vitreous surgery for Epiretinal membranes already have nuclear
sclerotic cataracts (yellowing of the center of the lens which
occurs commonly with aging), which can worsen after vitreous
surgery. Surgeons differ widely on the percentage of patients
that suffer cataract progression due to vitreous surgery.
A small number of patients (about
1%) will experience recurrence of the membrane after initial
success. For these patients the surgery can be repeated with
excellent success in most cases.
Retinal detachment can occur
after vitreous surgery for any reason, including Epiretinal membrane
repair. Opinions vary widely on the frequency of retinal detachment
after Epiretinal membrane surgery, ranging from estimates of
1.5% to 5%.
If you have
any further questions about the service provided by Central Florida
Retina Institute or if you would like to make an appointment,
please call (863) 682-7474 or call toll-free at 877-245-2020.
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