Spontaneous Separation of Macular Epiretinal Membrane Without Peripheral Posterior Vitreous Detachment

Abstract

Purpose: To describe findings of a patient with spontaneous separation of macular epiretinal membrane (ERM) associated with a limited posterior vitreous detachment. Methods: Case report. Results: A 69-year-old woman presented with metamorphopsia and loss of vision (20/200) in the left eye (OS) secondary to ERM. One month later, the vision improved (20/40−) following spontaneous separation of the ERM. However, residual epiretinal fibrotic membranes were adherent along the vascular arcades, causing persistent disabling metamorphopsia. During vitrectomy, peeling of the membranes from the vascular arcades demonstrated that the peripheral vitreous cortex had not separated around the macula. The metamorphopsia subsequently improved. Conclusions: This case demonstrates a unique finding at the vitreomacular interface, where spontaneous ERM separation was not associated with a peripheral vitreous detachment. The peripheral cortical vitreous remained intact, serving as a scaffold for membrane proliferation along the vascular arcades.