Spontaneous self-separation of an idiopathic epiretinal membrane: an OCT based imaging evidence

Author: Deepak Bhojwani (India)

Co-authors: Shail Vasavada, Aditya Sudhalkar, Abhay Vasavada

Purpose

To report a case of a 60-year-old gentlemen with idiopathic ERM and its spontaneous self separation through a 6 year old follow-up as evidenced on serial OCT scans.

Setting/Venue

Raghudeep Eye Hospital, Ahmedabad.

Methods

We retrospectively reviewed electronic medical records of a 58 year old gentlemen who came to us for cataract surgery opinion in 2014. He underwent detailed ocular examination and was found to have significant cataract in both eyes in 2014. he underwent both eyes cataract surgery in 2014 with good visual outcome. On follow-up visit in 2015 he developed Idiopathic ERM in his left eye which was confirmed on OCT scans. Since his visual acuity was good and he didn't had any symptoms of metamorphopsia we advised a serial follow-up with OCT scans. During his follow-up visit in 2020 we noted improved visual acuity and spontaneous separation of ERM in his left eye.

Results

In this case, serial imaging on OCT scans including Enface imaging spanning over 6 years showed spontaneous self-separation of ERM resulting in restoration of normal foveal contour and improved visual acuity.

Conlusions

Spontaneous self-separation of an idiopathic ERM from the retinal surface is a rare event. Two mechanisms have been proposed in the literature to explain the spontaneous ERM separation. The first and most common mechanism being the process of PVD induction. The second mechanism is a process resulting from the tangential traction created by the cells in the inner retinal layers which occurs in eyes with PVD. We believe that PVD induction caused self separation of ERM in our case.

Financial Disclosure

NIL