Macular Pucker: Cause and Treatment.
Look to New England's Macular Degeneration
Treatment Specialists for Answers.
Macular Pucker is also known as pre-retinal fibrosis, cellophane retinopathy, or epiretinal membrane. It is a condition where a thin membrane of scar-like tissue covers the surface of the macula. Such membranes glisten when examined, giving the appearance of cellophane. Macular pucker typically occurs in patients over 50 after a posterior vitreous detachment (PVD) has occurred. The membrane alone may not cause any significant vision problems, is not necessarily progressive, and may not require macular degeneration treatment.
A PVD may release fibrous tissue, which settles on the macula in the back of the eye, and begins the formation of the membrane. Macular puckers may also occur after retinal tears or detachments, severe trauma affecting the back of the eye, or previous retinal surgery. Some cases have no obvious preceding event and are considered idiopathic. The membrane may contract and can cause wrinkling of the retina which can cause distortion in vision. The distorted retina looks wrinkled and may looked "puckered". Generalized blurring may also occur, especially if there is associated macular edema caused by the traction of the contracting membrane upon the retina. The most specific symptom is visual distortion, especially straight lines turning into wavy lines.
In cases of visual distortion, surgery may be recommended. A surgical procedure called a vitrectomy, where the membrane may be carefully "peeled" off the retina, is usually very effective. Membrane peeling allows the retina to return to a more normal shape. Improved vision surgery is slow and gradual as the sensitive nerve tissue recovers, and may take 12 to 16 weeks.
