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Macular pucker

 

Macular pucker:
It is a scar tissue that is formed on the macula. It is also referred to as epiretinal membrane, cellophane maculopathy, retina wrinkle, premacular fibrosis, surface wrinkling retinopathy and internal membrane disease.
Causes: The development of macular pucker is similar to macular hole and is due to the separation of vitreous from the retinal surface. When the vitreous pulls away from the retina surface there is microscopic damage to it. When this heals damaged retina is replaced by a scar tissue on its surface. When the macular scar tissue contracts it causes the macula to wrinkle or pucker.


Symptoms: Patients are asymptomatic if the membrane is very thin. Distortion of lines or letters is noticed in some cases with thick and crumpled membranes. In advanced cases central scotoma or blind spot is noticed.

Diagnosis:
Optical coherence tomography: The retinal section clearly demonstrates the macular pucker on the retinal surface.
Fundus fluoresceine angiography: shows any changes in the macular area due to pull by the membrane.
Treatment: If the symptoms of vision distortion are mild no treatment is necessary. If the vision distortion affects daily activities surgery is recommended. Vitrectomy and removal of the scar tissue followed by silicone gel injection is recommended
 















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