title: Central Microscotoma: A Rare Presentation of Epiretinal Membranes.
abstract: OBJECTIVE
  Patients with a symptomatic epiretinal membrane (ERM) typically complain of metamorphopsia and decreased visual acuity. We describe three patients who presented with the single complaint of a central microscotoma due to ERM, an infrequent initial symptom of this entity.
  
  
  METHODS
  This is a retrospective, interventional, non-comparative case series. Three patients with the chief complaint of a central microscotoma related to ERMs who underwent pars plana vitrectomy by a single surgeon experienced full resolution of the preoperative microscotoma. Best-corrected visual acuity, fundus photography, and optical coherence tomography were obtained at each examination. A comprehensive neuro-ophthalmologic evaluation was performed in all cases, including magnetic resonance imaging of the orbits and brain, automated visual fields, multifocal electroretinography, multifocal visually evoked potentials, and blood tests.
  
  
  RESULTS
  Three eyes of three patients who presented with the initial sole complaint of a central microscotoma due to ERM are included in this series. A comprehensive neuro-ophthalmologic evaluation ruled out non-retinal etiologies. After months of observation, a pars plana vitrectomy with ERM and internal limiting membrane peeling was performed in all patients. Postoperatively, the patients experienced a complete resolution of their initial, isolated complaint of a central microscotoma.
  
  
  CONCLUSIONS
  Central microscotoma, as a rare stand-alone presentation of ERM, is described. This symptom resolved after a successful removal of the ERM. A greater awareness among clinicians that ERMs may present in this manner may help avoid excessive and costly medical evaluations.
authors.forename: Elona
authors.initials: E
authors.lastname: Dhrami-Gavazi
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Sepúlveda
authors.forename: Winston
authors.initials: W
authors.lastname: Lee
authors.forename: K Bailey
authors.initials: KB
authors.lastname: Freund
authors.forename: Sri Krishna
authors.initials: SK
authors.lastname: Mukkamala
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Odel
authors.forename: Stanley
authors.initials: S
authors.lastname: Chang
mesh_terms: D000368:Aged; D004596:Electroretinography; D019773:Epiretinal Membrane / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D005074:Evoked Potentials, Visual; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D012607:Scotoma / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology; D014821:Vitrectomy