A macular pucker, also known as epiretinal membrane, premacular fibrosis, or cellophane maculopathy, is a thin layer of tissue membrane that forms over the macula, the central area of the retina that is responsible for our central and reading vision.
Macular puckers often develop on their own as part of the natural aging process. Small particles that have drifted into the vitreous (the gel that fills the eye) settle dependently on the surface of the macula and are slowly transformed into a scar tissue matrix. Membranes may also result from other eye conditions such as retinal tears and detachments, ocular inflammation, retinal vascular diseases, and trauma.
Many epiretinal membranes do not disrupt vision. Other membranes may mature and begin to contract on the surface of the macula causing wrinkles and folds. Distortion and loss of vision may result from the wrinkling and “puckering” of the macula. Symptoms may vary from mild blurry vision to severe central visual dysfunction.
A patient who is sufficiently bothered by their distorted vision from macular pucker may benefit from surgical removal of their scar tissue membrane. A vitrectomy is performed in an outpatient surgery setting usually under a local anesthetic with mild sedation. Surgery is frequently extremely successful in helping patients to recover visual function previously impaired by macular pucker.
Dr. Cohen and Dr. Kanter have incorporated Jetrea, a recently FDA approved medication that is injected directly into the eye, for symptomatic vision loss secondary to vitreomacular adhesion, a specific subtype of macular surface disease.