Pathogenesis of idiopathic epiretinal membrane

Abstract

AbstractTo describe the pathophysiological events involved in the formation and progression of epiretinal membranes (ERMs).Epidemiologic studies have found a clear relationship between ERM formation, ageing, and posterior vitreous detachment. Increased prevalence of ERM is noted in the population older than 60 years, with peak prevalence between 70 and 79 years. Histologic studies of surgically obtained ERM specimens identified cellular and extracellular matrix components. A key element in ERM formation and its progression toward a contractile membrane is the transdifferentiation of those cellular components toward myofibroblasts. ERMs stiffness is a result of the proportion between its collagenous and non‐collagenous elements. Additionally, modifications of membrane macromolecules, such as accumulation of advanced glycation end products, which constitutes an age‐related phenomenon, may increase stiffness of the membrane and contribute to the fibrotic process.Retinal membranes have been described for more than 150 years and comprise the most common type of fibrocellular proliferation found at the vitreoretinal interface. Although patients with ERM can be asymptomatic when the membrane is thin and translucent, its progression to a thick, and contractile membrane may result in macular distortion, inducing metamorphopsia and loss of visual function. Understanding disease pathogenesis is essential in order to develop appropriate therapeutic approaches.