15 The vitreous adheres to the inside of the eye at the posterior lens capsule, peripheral retina, retinal vessels, perimacular region, and optic disk. The vitreous is the transparent gel that occupies the posterior segment of the eye and is composed primarily of water, collagen, hyaluronan, and hyalocytes. Herein, we review the basics of ERMs and propose an OCT-based classification system for ERMs. In order to fully harness these technological advances, a standardized classification system must be devised. 14 Imaging techniques, such as spectral-domain optical coherence tomography (SD-OCT) with three-dimensional reconstruction, have been introduced for this purpose. However, recent advances in imaging have allowed clinicians to more accurately diagnose and characterize ERMs and their associated complications, such as vitreomacular traction and macular hole. 6 – 13 Historically, ERMs were diagnosed and classified based on clinical examination findings alone. 2 Furthermore, an ERM can be classified as either idiopathic or secondary based on etiology. Clinically, an ERM can be classified as either cellophane macular reflex or preretinal macular fibrosis based on severity. 4, 5ĮRM is a pathologic fibrocellular membrane that lies immediately superjacent to the inner surface of the retina. The prevalence of ERM varies from 2.2% to 28.9% depending on the population being studied. 3 Most ERMs occur in individuals older than 50 years, and the prevalence of ERM increases as age increases. 2 Numerous potential risk factors for the development of an ERM have been identified, including race, ethnicity, sex, smoking, diabetes, arteriolar narrowing, and hypercholesterolemia however, the most consistently identified risk factor is age. 1 It has been estimated that 30 million people of advanced age in the US have an ERM in at least one eye. The symptoms associated with ERMs, especially metamorphopsia, can impair vision-related quality of life.

The clinical presentation of an ERM can range from completely asymptomatic, diagnosed on routine examination, to profoundly symptomatic with metamorphopsia, micropsia or macropsia, photopsia, decreased visual acuity (VA), and loss of central vision.

Epiretinal membrane (ERM), also known as macular pucker or cellophane maculopathy, is a disorder of the vitreomacular interface that can cause visual impairment.

Epiretinal membrane definition