Spontaneous separation of epiretinal membrane in young subjects: personal observations and review of the literature

Abstract

Young subjects should be counseled about the favorable prognosis for maintaining good vision and possible spontaneous membrane separation. Conservative observation is advocated if the visual disturbance is located temporally, as functional recovery and spontaneous membrane separation may occur. When the contracting forces of the immature ERM are stronger than its adhesions to the retina, the membrane may separate spontaneously.

Real-life experience after intravitreal ocriplasmin for vitreomacular traction and macular hole: a spectral-domain optical coherence tomography prospective study

“…The thin vitreous strands at the adhesion site seem to be a good predictor of VMT release, as there is no need for exceptional traction for the vitreous to be released. Regarding the presence of ERM, studies to date support the notion that ERM with fibrocellular proliferation can cause stronger adhesion between the macula and the vitreous, which does not facilitate separation of the vitreous from the macula [17,22], as it was shown in our study as well, although spontaneous ERM release rarely occurs [26].…”

Characteristics of epiretinal membranes according to the presence or absence of posterior vitreous detachment

“…5 If the outermost cortical layer of the vitreous constitutes the ERM, or if adhesion between the vitreous and the ERM is stronger than that between the ERM and ILM, spontaneous peeling of ERMs may occur concurrently with a PVD. [6][7][8] We reviewed fundus photographs in two published articles that reported spontaneous peeling of ERM. 6,8 Interestingly, radiating macular folds in the fundus photographs before development of a PVD were noted in four of five cases in those articles.…”

“…[6][7][8] We reviewed fundus photographs in two published articles that reported spontaneous peeling of ERM. 6,8 Interestingly, radiating macular folds in the fundus photographs before development of a PVD were noted in four of five cases in those articles. However, the mechanism for development of ERM in patients without a PVD remains unclear.…”

Juvenile idiopathische epiretinale Membran

“…Bei Jugendlichen, die entweder beschwerdefrei sind oder mit leichter Visusminderung erscheinen, empfehlen wir regelmä-ßige Kontrollen. Es sollte zunächst immer eine spontane Lösung der ERM abgewartet werden [7]. Nach chirurgischer Membranektomie sind bei den meisten Patienten ein deutlicher Visusanstieg und eine Reduktion der Metamorphopsien zu erwarten.…”