PMC4238755_01
Fundus photograph 18 months before presentation.. Notes: The opaque ERM bridges between multiple fixation points on the retinal surface, obscuring the view to the macula. Note that traction lines correspond with wrinkling of the ILM.. Abbreviations: ERM, epiretinal membrane; ILM, internal limiting membrane.
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This 32 year-old healthy man complained of visual loss in the right eye 14 months prior to presentation and he was referred for surgical peeling of an ERM (Figures 1-5) by two retina experts.
Red-free photograph of the right posterior pole.. Note: An opaque epiretinal membrane covers the macula resulting in superficial radial folds.
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This 32 year-old healthy man complained of visual loss in the right eye 14 months prior to presentation and he was referred for surgical peeling of an ERM (Figures 1-5) by two retina experts. Past fundus photograph 1.5 years ago revealed a dense macular gliosis with prominent radial stress line (best seen on infrared photography) throughout the posterior pole and centered around the thickest part of the membrane nasal to the disc (as noted by red-free photograph [Figure 2]).
Infrared photograph of the right posterior pole.. Note: An opaque epiretinal membrane covers the macula with prominent traction exerted on the inner retinal surface in the form of superficial radial folds.
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This 32 year-old healthy man complained of visual loss in the right eye 14 months prior to presentation and he was referred for surgical peeling of an ERM (Figures 1-5) by two retina experts.
Arteriovenous phase of fluorescein angiography transit.. Notes: Visible retinal vessels at the posterior pole appear tortuous. The superior and inferior vessels appear narrowed and the perimacular vessels are pulled towards the epicenter with prominent retinal striae.
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This 32 year-old healthy man complained of visual loss in the right eye 14 months prior to presentation and he was referred for surgical peeling of an ERM (Figures 1-5) by two retina experts.
Optical coherence tomography done 1 year before presentation revealed a diffuse epiretinal membrane being thin temporal to the fovea and very thick nasal to the fovea (epicenter) with marked thickening of the central fovea.
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This 32 year-old healthy man complained of visual loss in the right eye 14 months prior to presentation and he was referred for surgical peeling of an ERM (Figures 1-5) by two retina experts. Optical coherence tomography (OCT) done 1 year ago (Figure 5) revealed a diffuse ERM thin temporal to the fovea and very thick nasal to the fovea with marked thickening of the central fovea.
Fundus photograph of the right eye taken more than 1 year after the patient's initial presentation.. Notes: Epiretinal membrane (ERM) has spontaneously released and contracted nasally. Remnants of the ERM are still present as tiny, white, pre-retinal flakes at the superior-macular arcade. Traction on the fovea is now relieved and there is residual wrinkling of the internal limiting membrane. Note that the vessels in the macula region are no longer distorted compared with the previous pattern.
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Two months later, ophthalmic exam revealed 6/6 uncorrected visual acuity with findings of a residual rolled-over ERM supranasal to the fovea (Figure 6).
Serial horizontal optical coherence tomography scans demonstrate rupture of the epiretinal membrane (ERM) temporal to fovea with retraction of remaining ERM nasally and return of the normal foveal contour.
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ERM (Figure 7) accompanied by normalization of central foveal thickness (Figure 8). ERM rupture could be noted with one edge ruptured temporally and the nasal edge rolling over (Figure 9).
Close up view of horizontal optical coherence tomography scan showing normal foveal contour.
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ERM (Figure 7) accompanied by normalization of central foveal thickness (Figure 8). ERM rupture could be noted with one edge ruptured temporally and the nasal edge rolling over (Figure 9).
Close up view of horizontal optical coherence tomography scan just above the foveal plane showing edge of ruptured epiretinal membrane (ERM) (white arrow) temporally and rolled-over hyper-reflective ERM nasally (black arrow).
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ERM (Figure 7) accompanied by normalization of central foveal thickness (Figure 8). ERM rupture could be noted with one edge ruptured temporally and the nasal edge rolling over (Figure 9).