Under what condition is PPV with ILM peel considered for ERM?

Under what condition is PPV with ILM peel considered for ERM?

• A. If BCVA > 20/40 or significant intraretinal cysts
• B. Only if BCVA is worse than 20/200
• C. Always, for all ERMs
• D. Never surgical

Answer: (A)

When deciding about pars plana vitrectomy with ILM peeling for an epiretinal membrane, the focus is on functional impact and retinal structure. This surgery isn’t automatic for every ERM; it’s considered for patients who still have relatively good acuity but have symptoms or signs that suggest ongoing traction and potential progression. If best-corrected visual acuity is better than 20/40 yet there are significant intraretinal cysts indicating tractional edema, removing the membrane and peeling the ILM can relieve the traction, reduce metamorphopsia, and help preserve or improve vision. The presence of these cystic changes signals that intervention could be beneficial even when acuity isn’t severely reduced.

When deciding about pars plana vitrectomy with ILM peeling for an epiretinal membrane, the focus is on functional impact and retinal structure. This surgery isn’t automatic for every ERM; it’s considered for patients who still have relatively good acuity but have symptoms or signs that suggest ongoing traction and potential progression. If best-corrected visual acuity is better than 20/40 yet there are significant intraretinal cysts indicating tractional edema, removing the membrane and peeling the ILM can relieve the traction, reduce metamorphopsia, and help preserve or improve vision. The presence of these cystic changes signals that intervention could be beneficial even when acuity isn’t severely reduced.