Vitrectomy With Membrane Peeling for Vasocentric Idiopathic Epiretinal Membranes

Abstract

Purpose: 

To report the clinical course and outcome of surgery for idiopathic epiretinal membranes (ERMs) centered on retinal blood vessels.

Methods: 

Retrospective observational case series review of the case records of 15 patients with idiopathic ERMs overlying retinal blood vessels, of whom 9 underwent vitrectomy with membrane peeling. The patients attended two eye departments under the care of four vitreoretinal surgeons with a total of more than 50 years of surgical experience.

Results: 

The patients were aged 12–74 years (mean = 34.3 years). Difficulties were experienced in achieving vitreoretinal and membranoretinal separation in the 9 eyes undergoing vitreous microsurgery. Recurrent ERM formation occurred in 8 of these eyes (89%) of which 6 underwent revision vitrectomy. Visual improvement was achieved in 55% of patients. Mean follow-up was 2.5 years.

Conclusions: 

The authors describe a subgroup of patients with idiopathic ERMs in which the membrane is centered over a large retinal vessel. This occurs predominantly but not exclusively in a young age group. Surgical removal is characterized by a high recurrence rate.

In Brief

In this retrospective observational study, the authors focus on a subgroup of epiretinal membranes centered over large retinal vessels. Surgical removal of these membranes proved to be difficult, with high recurrence rate observed. The clinical picture and proposed theoretical explanation of this condition is discussed.