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Epiretinal membrane or macular pucker is a disease of the eye in response to changes in the vitreous humor or more rarely, diabetes.Sometimes, as a result of immune system response to protect the retina, cells converge in the macular area as the vitreous ages and pulls away in posterior vitreous detachment (PVD).
Bruch's membrane or lamina vitrea [1] is the innermost layer of the choroid of the eye. It is also called the vitreous lamina or Membrane vitriae , because of its glassy microscopic appearance. It is 2–4 μm thick.
OCT findings in Berlin's edema have included increased reflectivity because of photoreceptor outer segment disruption and, less frequently, hyper-reflectivity of inner retinal layers. Other findings include increased central retinal thickness, a low signal triangular area below the foveal pit, and outer retinal thickening.
The causes of macular edema are numerous and different causes may be inter-related. It is commonly associated with diabetes.Chronic or uncontrolled diabetes type 2 can affect peripheral blood vessels including those of the retina which may leak fluid, blood and occasionally fats into the retina causing it to swell.
The vitreous humor is a transparent, colorless, gelatinous mass that fills the space in the eye between the lens and the retina.It is surrounded by a layer of collagen called the vitreous membrane (or hyaloid membrane or vitreous cortex) separating it from the rest of the eye.
The retina can be reattached even with the membrane in place. The other type forms as very thick contractile membranes which pull at the retina. These are opaque and block the light falling on the retina so the retinal reattachment surgery needs to be performed after manually peeling the membrane off. [11] [12]
Surgery involves gland replacement, not excision, by anchoring the membrane to the orbital rim or using a pocket technique. [3] In severely infected cases, preoperative antibiotics may be necessary by means of antibiotic eye ointment. [3] Removal of the gland was once an acceptable treatment, and made the eye appear completely normal. [5]
In early stage of lipaemia retinalis, creamy-white discoloration of retinal blood vessels occurs and in extreme cases the fundus become salmon red colour. [2] Retinal changes occur in the peripheral vessels gradually progress to entire fundus. [3] Symptoms are caused by an increase in the level of chylomicron in the retinal circulation. [4]