Tearing and folding of the retinal internal limiting membrane associated with macular epiretinal membrane.
OBJECTIVE
To describe the clinical and histologic features of a particular form of macular epiretinal membrane.


METHODS
The charts of all patients operated for macular epiretinal membrane by a single surgeon (E.H.B.) between June 2001 and January 2005 were retrospectively reviewed. Patients with macular epiretinal membrane associated with tearing and folding of the internal limiting membrane (ILM) were identified and the following parameters were recorded when available: age, gender, best-corrected visual acuity before and after vitrectomy; optical coherence tomography; pre-, intra-, and postoperative macular status; intraoperative staining by indocyanine green; histology.


RESULTS
Twenty-three of 268 eyes (8.6%) with macular epiretinal membrane were associated with tearing and folding of the ILM, forming a whitish prominent band on the surface of the retina. The mean age of the patients was 68.6 years with a significant female predominance (78.3%). The vitreous was completely detached in 21 eyes. After surgical peeling, the mean visual gain was 3.2 Early Treatment Diabetic Retinopathy Study lines. No recurrence was observed.


CONCLUSIONS
Tearing and folding of the ILM was associated with macular epiretinal membranes in 8.6% of cases. The ILM was probably torn during posterior hyaloid detachment, but the pathogenesis has not been clearly elucidated. The surgeon should begin to peel the macular epiretinal membrane by grasping the folded ILM to ensure complete removal of the ILM together with the epiretinal membrane. The postoperative visual prognosis was good.
Bovey
Etienne H
EH
Vitreoretinal Surgery Unit, Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland. etienne.bovey@ophtal.vd.ch
Uffer
Sylvie
S
D000368:Aged; D000369:Aged, 80 and over; D001485:Basement Membrane / Q000293:injuries* / Q000473:pathology*; D004396:Coloring Agents; D019773:Epiretinal Membrane / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D012167:Retinal Perforations / Q000175:diagnosis* / Q000601:surgery; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy
D004396:Coloring Agents; D007208:Indocyanine Green