Epiretinal Membrane

Epiretinal membrane (ERM) is a prevalent macular condition characterized by a pathological, hyperreflective layer on the inner retinal surface. It is classified as idiopathic (primary) or secondary, with idiopathic ERM being the most common and typically associated with posterior vitreous detachment. Secondary ERM occurs alongside pre-existing ocular conditions, such as diabetic retinopathy, retinal vein occlusion, and trauma. Clinically, ERMs vary in severity, from asymptomatic cases to those causing metamorphopsia and decreased visual acuity. Optical coherence tomography (OCT) has revolutionized ERM diagnosis and classification, providing insights into associated pathologies such as lamellar macular holes, pseudoholes, and foveoschisis. Recent grading systems based on OCT highlight the morphological stages of ERM progression, from mild forms with minimal disruption to advanced stages with significant retinal distortion. Surgical excision remains the sole effective treatment for ERM, and the decision to operate requires a careful risk-benefit analysis. Predictors for surgical outcomes include OCT findings such as baseline cystoid macular edema and ellipsoid zone disruption. Despite the high success rate of pars plana vitrectomy in restoring visual acuity, complications such as retinal breaks, macular holes, cataracts, and retinal detachment may arise. Postoperative recurrence of ERM is observed in less than 20% of cases, mitigated by inner limiting membrane (ILM) peeling.