macular pucker; epiretinal membrane (ERM); preretinal membrane; cellophane maculopathy; retina wrinkle; surface wrinkling retinopathy; premacular fibrosis; internal limiting membrane disease

scar tissue that has formed on the macula retinae Etiology: 1) vitreous detachment 2) retinal detachment 3) uveitis 4) diabetic retinopathy 5) eye trauma Pathology: 1) when vitreous pulls away from the retina, microscopic damage to the retina's surface may occur 2) the retina begins a healing process to the damaged area & forms scar tissue, or an epiretinal membrane, firmly attached to the retina surface 3) when the scar tissue contracts, it causes the retina to wrinkle, or pucker, usually without any effect on central vision 4) if the scar tissue has formed over the macula, central vision becomes blurred & distorted Clinical manifstations: 1) usually affects one eye; other eye may be affected later 2) blurry vision 3) distorted central vision 4) difficulty in seeing fine detail & reading small print 5) blind spot 6) severe vision loss is uncommon Differential diagnosis: macular hole Management: 1) usually requires no treatment 2) usually does not affect activities of daily life, such as reading & driving 3) surgery: vitrectomy rarely required - macular pucker may rarely grow back Prognosis: 1) for most people, vision remains stable & does not get progressively worse. 2) sometimes the scar tissue separates from the retina, & the macular pucker resolves

References

National Eye Institute: Macular Pucker http://www.nei.nih.gov/health/pucker/index.asp