Epiretinal membrane: an overview and update

Abstract Epiretinal membrane (ERM) is a frequently diagnosed macular disease associated with aging, characterized by a fibrous membrane forming on the internal limiting membrane (ILM) and leading to visual dysfunctions such as metamorphopsia. Various hypotheses regarding the pathology of metamorphopsia have been proposed; however, the complete pathophysiologic mechanism underlying ERM remains unclear. Optical coherence tomography (OCT) provides detailed images enabling precise diagnosis and characterization of ERM, with several recent studies using the latest OCT imaging techniques. Surgical removal of ERM is the only treatment option; however, criteria for surgical intervention are not established, complicating the decision-making processes. Furthermore, the debate on whether simultaneous peeling of the ILM during ERM surgery enhances outcomes or poses unnecessary risks is ongoing, with no definite conclusion having yet been reached. This review also focuses on epiretinal proliferation, which is different from ERM and is characteristic of lamellar macular hole (LMH). Recently, diagnostic criteria for LMH and related diseases were proposed. Reports on effective surgical procedures for LMH exist, although more research is needed to confirm the long-term outcomes. Thus, this review article aims to provide an overview and updated knowledge of ERM, LMH, and related diseases.