Macular Pucker

Opaque membrane obscures the visibility of the macula and drags the paramacular vessels. 

  • The formation of thick, coarse, dense membrane which causes marked distortion of the macula that may sometimes elevates the fovea off the pigment epithelium. (puckering the macula)

Clinical features:

  • Symptoms:
    • Markedly decreased vision or loss of central vision
    • Metamorphopsia
    • Diplopia
    • Central photopsia or macropsia
  • Signs:
    • Thick, opaque membrane may obscure the visibility of the macula
    • Foveal ectopia
    • Commonly causes dragging of the paramacular retinal vessels
  • Chronic cases may be complicated with retinal pigment epithelium changes, retinal vascular leakage, macular hole, macular edema, hemorrhage, foveal cyst or choroidal neovascularization.
  • Fluorescein angiogram demonstrates:
    • Dragged perifoveal vessel
    • Dye leakage
  • Management: vitreoretinal surgery should be considered when significant visual reduction (BCVA of < 20/50) has occurred.