Reproliferation of Idiopathic Epiretinal Membrane after Spontaneous Separation

Jeong Min Kwon; Jong Heon Lee; Kyong Ho Kim; Sung Who Park; Ji Eun Lee; Ik Soo Byon

doi:10.3341/jkos.2016.57.4.682

Journal List > J Korean Ophthalmol Soc > v.57(4) > 1010572

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Kwon, Lee, Kim, Park, Lee, and Byon: Reproliferation of Idiopathic Epiretinal Membrane after Spontaneous Separation

Case Report

J Korean Ophthalmol Soc 2016;57(4):682-685.

Published online: 3 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.4.682

Reproliferation of Idiopathic Epiretinal Membrane after Spontaneous Separation

Jeong Min Kwon, MD^1,², Jong Heon Lee, MD^1,², Kyong Ho Kim, MD^1,², Sung Who Park, MD^3,⁴, Ji Eun Lee, MD, PhD^3,⁴, Ik Soo Byon, MD^1,^2,^3,

¹Department of Ophthalmology, Pusan National University Yangsan Hospital, Yangsan, Korea

²Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea

³Department of Ophthalmology, Pusan National University School of Medicine, Yangsan, Korea

⁴Department of Ophthalmology, Pusan National University Hospital, Busan, Korea

Address reprint requests to Ik Soo Byon, MD Department of Ophthalmology, Pusan National University Yangsan Hospital, #20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea Tel: 82-55-360-2592, Fax: 82-55-360-2161 E-mail: isbyon@naver.com

Received 10 July 2015 Revised 20 December 2015 Accepted 1 February 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the reproliferation of membrane after a spontaneous separation in a patient with idiopathic epiretinal membrane (ERM).

Case summary

A 62-year-old woman complained of metamorphopsia in the left eye. Her vision without correction was 0.8. On fundus examination, the epiretinal membrane was covering the fovea with posterior vitreous detachment. Optical coherence tomography (OCT) showed the ERM and thickened macula. Retinal break, intraocular inflammatory disease, and retinal vascular disease were not noted. We diagnosed her with idiopathic ERM and followed up regularly. At month 7, a partial separation of the membrane from the retinal surface was noted. At month 12, complete spontaneous separation of the ERM from the macula except that in the temporal area was accompanied by improvement of vision to 1.0. OCT, showing recovery of the fovea contour. However, her corrected vision decreased to 0.7 at month 17, and the ERM was again observed to cover the macula. Thickening of the ERM progressed further, and her corrected vision decreased to 0.5 at month 21.

Conclusions

Spontaneous separation of membrane is a rare phenomenon in idiopathic ERM. Reproliferation of membrane can develop and induce visual impairment. Therefore, regular examination is recommended in patients with spontaneous separation of membrane.

Keywords: Idiopathic epiretinal membrane, Metamorphopsia

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Figure 1.

Fundus photograph and optical coherence tomography (OCT) images during the follow-up period. (A) Baseline fundus photograph demonstrates the opaque epiretinal membrane (ERM) covering the fovea. Thickened macula and retinal folding were detected in the baseline OCT images. The central macular thickness was 439 μm. The best corrected visual acuity (BCVA) was 0.8. (B) At 12 months, the ERM was spontaneously separated from the retina. OCT scan shows a scrolled edge of the membrane (arrows) and foveal contour recovery. The macular thickness decreased to 367 μm. BCVA improved to 1.0. (C) At 21 months, reproliferative ERM covered the macula. The macular thickness increased to 469 μm. BCVA decreased to 0.5. (D) Six months after epiretinal membrane removal, retinal folding disappeared, and macular thickness decreased to 392 μm. Her vision improved to 0.9.

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