Retinal lesion that simulates macular hole without actual tissue loss.
Clinical Features
Altered light reflex and darker appearance of the fovea
Steepening of the normal foveal depression
Most commonly seen in association with epiretinal membrane contraction, vitreomacular traction syndromes, proliferative diabetic retinopathy, rhegmatogenous retinal detachment, intraocular inflammation, trauma and venous occlusive disease
Optical coherent tomography (OCT) demonstrates:
Steepening of foveal contour
Full thickness retinal tissue is present
Reflective epiretinal membrane layer is present on the surface of the retina
Fluorescein angiography often reveals normal fluorescence except if traction-induced retinal vascular disruption present.
Management
Treatment of the underlying causes of epiretinal membrane.
Observation of progressive contraction, which may lead to macular edema.
Surgical vitrectomy to peel the epiretinal membrane may be indicated in patients with worsening vision of 20/80 or less.
