Unexplained vision loss following removal of epiretinal membrane.
OBJECTIVE
To report unexplained severe central vision loss accompanied by a dense central scotoma as an uncommon complication following epiretinal membrane removal.


METHODS
Retrospective, multicentred, case series.


RESULTS
Six patients underwent uncomplicated vitrectomy surgery between 2000 and 2007 at four separate retina practices for removal of an epiretinal membrane. Preoperative vision ranged from 20/60 to 20/100, with a median of 20/70. On the first day postoperatively, all patients noted decreased vision ranging from counting fingers to light perception and were found to have a dense central scotoma. Posterior segment examination revealed a white, oedematous macula in all affected eyes. Vision improved minimally during the follow-up period, which ranged from 2 months to 5 years. The final vision ranged from 20/200 to hand movements. No anatomic or physiologic cause for the decreased vision and central scotoma was identified.


CONCLUSIONS
While uncommon, severe, permanent, central vision loss accompanied by a dense central scotoma can occur following epiretinal membrane removal and should be considered when assessing the risks and benefits of such surgery.
Roe
R H
RH
The San Francisco Retina Foundation, San Francisco, California, USA.
McDonald
H R
HR
Fu
A D
AD
Lahey
J M
JM
Wendel
R T
RT
Pearlman
J A
JA
Monahan
P M
PM
Jumper
J M
JM
Johnson
R N
RN
Ai
E
E
Cunningham
E T
ET
D000368:Aged; D001766:Blindness / Q000209:etiology*; D019773:Epiretinal Membrane / Q000601:surgery*; D005260:Female; D006801:Humans; D008269:Macular Edema / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012607:Scotoma / Q000209:etiology; D014821:Vitrectomy / Q000009:adverse effects*