First Author: D.Sousa PORTUGAL
Co Author(s): S. Vaz-Pereira N. Pinto Ferreira M. Faria
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Idiopathic epiretinal membranes (ERM) are, without surgical intervention, typically a stable or slowly progressive condition. We report a case of spontaneous separation of an ERM in a patient that experienced associated posterior vitreous detachment (PVD).
Ophthalmology Dept., Hospital de Santa Maria, Lisbon, Portugal.
Case-report with descriptive follow-up based on data from clinical records and analysis of spectral-domain optical coherence tomography (OCT).
A 65-year-old male patient presented with metamorphopsia and bilateral reduced visual acuity. On examination, best-corrected visual acuity (BCVA) was 20/32 OD and 20/25 OS. A bilateral ERM blunting normal foveal contour was diagnosed and confirmed using OCT. During follow-up, BCVA OS worsened to 20/60 and the patient complained of acute-onset floaters. Fundoscopy revealed the presence of a PVD and a large premacular floater. OCT confirmed the release of ERM at the macula with restoration of the foveal depression and associated PVD. The gliotic tissue of the ERM later collapsed into the anterior vitreous and BCVA recovered to 20/32.
Self-resolution of ERM has been more often documented with the advances in OCT, especially in eyes without preexisting PVD. The search for OCT findings, which may predict likelihood of spontaneous resolution, may help avoid unnecessary pharmacologic and/or surgical interventions. It should be noted however, that it may be difficult to differentiate a thickened posterior hyaloid membrane from an ERM with non-invasive imaging techniques.