EPIRETINAL MACULAR MEMBRANES IN EYES WITH ATTACHED POSTERIOR CORTICALVITREOUS

Background: The authors define the clinical and anatomic characteristi cs of patients who had epiretinal membrane formation and traction over the macula in the absence of vitreous detachment from the retina. Met hods: Patients were treated and followed by one surgeon (JCF). All pat ients had epiretinal membrane formation over the macula without vitreo us detachment. The clinical and surgical findings of these patients we re compared along with histopathologic examination of the removed epir etinal membranes and posterior cortical vitreous. Results: Fourteen pa tients were identified over a 9.75-year period. All patients had a thi n and transparent-or at most minimally translucent-membrane overlying the posterior pole causing traction. The membrane appeared continuous with the posterior hyaloid face. At vitrectomy, no vitreous detachment was found in any eye. Transmission electron microscopy of all three s pecimens tested found collagen of less than 16 nanometers in diameter, consistent with native vitreous collagen. After surgery, visual acuit y improved in 13 of 14 eyes, was 20/50 or better in 12 eyes, and was 2 0/25 or better in 7 eyes. Conclusion: Epiretinal membrane formation ca n occur in eyes without vitreous detachment probably because of cellul ar growth along the posterior hyaloid face. Such eyes respond particul arly well to surgery.