Macular pucker is the wrinkling of the retina, the layers of cells lining the back of the eye that are responsible for vision. They're in the area of the macula, the central point of clear vision on the retina. Macular pucker is also known as epiretinal membrane (ERM) or surface wrinkling retinopathy (SWR). Macular puckers result in vision loss ranging from mild to severe, depending on the degree of wrinkling, and may require surgical repair. Several conditions are associated with an increased risk of macular pucker.
Posterior Vitreous Detachment
Posterior vitreous detachment (PVD) is the detachment of the vitreous--the jelly that forms the central part of the eye--from the retina. When people age, the vitreous shrinks and pulls away from the retina. The retinal surface becomes inflamed, and scarring develops on the surface of the retina. This thin layer of scar tissue cells shrinks over time and can create wavy, distorted vision if the shrinking occurs over the macula, says ophthalmologist and retinal specialist Allen Ho, M.D.
Retinal Tears or Detachment
The retina can become torn in places or completely detached from the back of the eye. Certain medical conditions, such as nearsightedness and diabetes, increase the chance of retinal tears or detachment. Eye trauma also increases the risk. PVD can cause retinal detachment if the retina adheres to the vitreous as it shrinks. Retinal tears or detachment cause scarring on the surface of the retina, which can lead to macular puckering.
Medical Conditions
Macular pucker occurs more frequently in people with certain medical conditions. Proliferative retinopathy--damage to blood vessels caused by diabetes--may lead to macular pucker, according to the Eye Centers of Florida. Uveitis can also cause scarring that leads to macular pucker, the Eye Centers of Florida medical practice says. Uveitis is an inflammation of the uvea. The uvea includes the iris (the colored part of the eye) as well as the choroid, the layer of tissue between the sclera (the white part of the eye) and the retina. Macular puckers are also more common in people with high blood pressure, says the Eye Physicians of Sussex County medical practice.
