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Epimacular membrane secondary to an optic nerve head lesion
  1. Dhananjay Shukla,
  2. Abhishek Sharan
  1. Retina-Vitreous Service, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
  1. Correspondence to Dr Dhananjay Shukla, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, 1 Anna Nagar, Madurai 625 020, Tamil Nadu, India; daksh66{at}gmail.com

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A 57-year-old woman presented to us with blurred vision in her right eye for approximately a year. She gave no history of any systemic illness, ocular surgery or trauma. Best-corrected visual acuity (BCVA) was 20/70 in the right eye and 20/20 in the left. The anterior segments were unremarkable in both eyes. Fundus examination of right eye showed a tuft of anomalous papillary vessels with adjoining epimacular membrane (EMM) (figure 1A). Fundus of the left eye was normal. There was no evidence of posterior vitreous detachment or any coexistent retinal pathology in either eye. Fluorescein angiography of the right eye showed delayed filling of the papillary aneurysms with characteristic erythrocyte–plasma interface, as well as distortion and leakage of parafoveal capillaries (figure 1B). Optical coherence tomography (OCT; Stratus OCT; Carl Zeiss Meditec, Dublin, California, USA) of the right eye confirmed the EMM, central foveal thickness was 556 μm (figure 1C). A vertical OCT scan also demonstrated the layering of erythrocytes in the aneurysms (figure 1D). Systemic evaluation and neuroimaging revealed no cutaneous or central nervous system involvement. There was no family history of any ocular or systemic disease. The patient's daughter was also screened; she had unremarkable fundus and systemic examinations. The patient's parents and siblings were not available for evaluation. Surgery was offered to the patient to remove the EMM. With informed consent of the patient, she underwent pars plana vitrectomy in the right eye. One month postoperatively, BCVA improved in the right eye with a corresponding decrease in macular thickness (figure 1E,F). The visual outcome was maintained over the follow-up. This study was performed in compliance …

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