Idiopathic Epiretinal Membrane and Vitreomacular Traction
Publication Date: February 1, 2020
Last Updated: March 14, 2022
Recommendations
Diagnosis
Optical Coherence Tomography
Spectral domain OCT is a highly sensitive and routine method used to diagnose and characterize VMA, ERM, VMT, and the associated retinal changes.
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Discussion with Patient
Patients should be informed that the majority of ERMs will remain relatively stable and do not require therapy.
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Patients should also be reassured that there is a very successful surgical procedure that could address worsening symptoms or decreasing visual acuity.
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Furthermore, patients should be encouraged to periodically test their central vision monocularly in order to detect changes that may occur over time, such as increasing metamorphopsia and/or development of a small, central scotoma.
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Educating patients about the signs and symptoms of progression and regular monocular Amsler grid testing are both important. Although the visual acuity rarely improves spontaneously, it may worsen. If patients' symptoms worsen, a vitrectomy could be considered. Patients do not typically improve without vitrectomy surgery when the area of VMT is broad (>1500 μm), when there is an accompanying pathologic detachment of the macula, or when the presenting visual acuity is poor.
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Appropriate intervention should be made with careful informed consent and a discussion of the risk-benefit ratio of surgery.
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Title
Idiopathic Epiretinal Membrane and Vitreomacular Traction
Authoring Organization
American Academy of Ophthalmology