Epiretinal membrane: a review

Adrian T. Fung*, Justin Galvin, Tuan Tran

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

34 Citations (Scopus)


The prevalence of epiretinal membrane (ERM) is 7% to 11.8%, with increasing age being the most important risk factor. Although most ERM is idiopathic, common secondary causes include cataract surgery, retinal vascular disease, uveitis and retinal tears. The myofibroblastic pre-retinal cells are thought to transdifferentiate from glial and retinal pigment epithelial cells that reach the retinal surface via defects in the internal limiting membrane (ILM) or from the vitreous cavity. Grading schemes have evolved from clinical signs to ocular coherence tomography (OCT) based classification with associated features such as the cotton ball sign. Features predictive of better prognosis include absence of ectopic inner foveal layers, cystoid macular oedema, acquired vitelliform lesions and ellipsoid and cone outer segment termination defects. OCT-angiography shows reduced size of the foveal avascular zone. Vitrectomy with membrane peeling remains the mainstay of treatment for symptomatic ERMs. Additional ILM peeling reduces recurrence but is associated with anatomical changes including inner retinal dimpling.

Original languageEnglish
Pages (from-to)289-308
Number of pages20
JournalClinical and Experimental Ophthalmology
Issue number3
Early online date3 Mar 2021
Publication statusPublished - Apr 2021


  • ectopic inner foveal layer
  • epiretinal membrane
  • macular pucker
  • myofibroblasts
  • pre-macular fibrosis


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