It is not clear what determines the formation of the macular pucker (also referred to as epiretinal membrane): it can occur spontaneously, more frequently after 50 years and may be secondary to inflammatory processes, after retinal detachment or laser treatment. The epiretinal membrane (or macular pucker) is a disease affecting the eye in the border between the vitreous and macular area, that part of the central retina that deals with detailed vision, such as reading or driving a vehicle.
The inner limiting membrane which normally delimits the boundary between the vitreous and the retina, thickens and tends to wrinkle for the cell proliferation along the inner surface and the production of fibrous tissue by the accessory cells to the retina.
They determine tractions that generate radial folds and alter the normal course of the retinal vessels causing disorders to metabolic exchange with a consequent thickening of the macula. The visual impairment can vary greatly, from none to severe with a very slow period of evolution. The patient generally experiences a blurred vision, a distortion of the images (metamorphopsia), sometimes diplopia (double vision).
The main symptom which consists the deformation of images is identified with the Amsler test, a grid on which the patient draws the distortion of the perceived images.
The Center of Dr. Alberto Bellone is one among the Centers of Excellence for the diagnosis and treatment of macular pucker.
Epiretinal membrane therapy is surgical and is based on vitrectomy (removal of the vitreous body), peeling of the pucker and the internal limiting membrane.
With surgery, it is possible to achieve retinal integrity: this results in improved visual capability with reduced symptoms such as blur and image distortion.
Epiretinal membrane removal is performed in local anaesthesia and does not require hospitalization. It is almost painless, with a quick return to social life.