Macular Pucker and Vitreomacular Traction

  • Thomas H. Williamson


Idiopathic epiretinal membrane formation in the macula is also stimulated by posterior vitreous detachment, giving the clinical entities of macular pucker or cellophane ­maculopathy. It is postulated that the PVD damages the internal limiting membrane stimulating microglial cells proliferation and fibrosis (Messmer et al. 1998; Snead et al. 2004). Myofibroblastic activity may be present (De Juan et al. 1985) and may be commoner in younger patients (Smiddy et al. 1992).


Retinal Detachment Macular Hole Retinal Vein Occlusion Cystoid Macular Oedema Branch Retinal Vein Occlusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

macula (539,416 KB)


  1. Allen AW Jr, Gass JD (1976) Contraction of a perifoveal epiretinal ­membrane simulating a macular hole. Am J Ophthalmol 82(5):684–691PubMedGoogle Scholar
  2. Carney MD, Jampol LM (1987) Epiretinal membranes in sickle cell retinopathy. Arch Ophthalmol 105(2):214–217PubMedCrossRefGoogle Scholar
  3. Cherfan GM, Smiddy WE, Michels RG et al (1988) Clinicopathologic correlation of pigmented epiretinal membranes. Am J Ophthalmol 106(5):536–545PubMedCrossRefGoogle Scholar
  4. Cherfan GM, Michels RG, de Bustros S et al (1991) Nuclear sclerotic cataract after vitrectomy for idiopathic epiretinal membranes causing macular pucker. Am J Ophthalmol 111(4):434–438PubMedGoogle Scholar
  5. Chung SE, Kim KH, Kang SW (2009) Retinal breaks associated with the induction of posterior vitreous detachment. Am J Ophthalmol 147(6):1012–1016PubMedCrossRefGoogle Scholar
  6. Cox MS, Azen SP, Barr CC et al (1995) Macular pucker after successful surgery for proliferative vitreoretinopathy. Silicone study report 8. Ophthalmology 102(12):1884–1891PubMedGoogle Scholar
  7. de Bustros S, Rice TA, Michels RG et al (1988a) Vitrectomy for ­macular pucker. Use after treatment of retinal tears or retinal detachment. Arch Ophthalmol 106(6):758–760PubMedCrossRefGoogle Scholar
  8. de Bustros S, Thompson JT, Michels RG et al (1988b) Vitrectomy for idiopathic epiretinal membranes causing macular pucker. Br J Ophthalmol 72(9):692–695PubMedCrossRefGoogle Scholar
  9. de Bustros S, Thompson JT, Michels RG et al (1988c) Nuclear sclerosis after vitrectomy for idiopathic epiretinal membranes. Am J Ophthalmol 105(2):160–164PubMedGoogle Scholar
  10. De Juan E Jr, Lambert HM, Machemer R (1985) Recurrent ­proliferations in macular pucker, diabetic retinopathy, and retrolental fibroplasialike disease after vitrectomy. Graefes Arch Clin Exp Ophthalmol 223(4):174–183PubMedCrossRefGoogle Scholar
  11. Desatnik H, Treister G, Moisseiev J (1999) Spontaneous separation of an idiopathic macular pucker in a young girl. Am J Ophthalmol 127(6):729–731PubMedCrossRefGoogle Scholar
  12. Ghazi-Nouri SM, Tranos PG, Rubin GS et al (2006) Visual function and quality of life following vitrectomy and epiretinal membrane peel surgery. Br J Ophthalmol 90(5):559–562PubMedCrossRefGoogle Scholar
  13. Grewing R, Mester U (1996) Results of surgery for epiretinal membranes and their recurrences. Br J Ophthalmol 80(4):323–326PubMedCrossRefGoogle Scholar
  14. Guillaubey A, Malvitte L, Lafontaine PO et al (2007) Incidence of retinal detachment after macular surgery: a retrospective study of 634 cases. Br J Ophthalmol 91(10):1327–1330PubMedCrossRefGoogle Scholar
  15. Haritoglou C, Gandorfer A, Gass CA et al (2003) The effect of indocyanine-green on functional outcome of macular pucker surgery. Am J Ophthalmol 135(3):328–337PubMedCrossRefGoogle Scholar
  16. Haritoglou C, Gandorfer A, Schaumberger M et al (2004a) Trypan blue in macular pucker surgery: an evaluation of histology and functional outcome. Retina 24(4):582–590PubMedCrossRefGoogle Scholar
  17. Haritoglou C, Eibl K, Schaumberger M et al (2004b) Functional outcome after trypan blue-assisted vitrectomy for macular pucker: a prospective, randomized, comparative trial. Am J Ophthalmol 138(1):1–5PubMedCrossRefGoogle Scholar
  18. Korobelnik JF, Hannouche D, D’Hermies F et al (1998) Silicone oil removal combined with macular pucker dissection: a retrospective review of 14 cases. Retina 18(3):228–232PubMedCrossRefGoogle Scholar
  19. Laatikainen L, Immonen I, Summanen P (1989) Peripheral retinal angiomalike lesion and macular pucker. Am J Ophthalmol 108(5):563–566PubMedGoogle Scholar
  20. Li K, Wong D, Hiscott P et al (2003) Trypan blue staining of internal ­limiting membrane and epiretinal membrane during vitrectomy: visual results and histopathological findings. Br J Ophthalmol 87(2):216–219PubMedCrossRefGoogle Scholar
  21. Lobes LA Jr, Burton TC (1978) The incidence of macular pucker after retinal detachment surgery. Am J Ophthalmol 85(1):72–77PubMedGoogle Scholar
  22. Machemer R (1990) Peripheral retinal angiomalike lesion and macular pucker. Am J Ophthalmol 109(2):244PubMedGoogle Scholar
  23. Maguire AM, Smiddy WE, Nanda SK et al (1990) Clinicopathologic correlation of recurrent epiretinal membranes after previous surgical removal. Retina 10(3):213–222PubMedGoogle Scholar
  24. Martinez J, Smiddy WE, Kim J, Gass JD (1994) Differentiating macular holes from macular pseudoholes. Am J Ophthalmol 117(6):762–767PubMedGoogle Scholar
  25. Mason JO III, Kleiner R (1997) Combined hamartoma of the retina and retinal pigment epithelium associated with epiretinal membrane and macular hole. Retina 17(2):160–162PubMedGoogle Scholar
  26. McDonald HR, de Bustros S, Sipperley JO (1990) Vitrectomy for epiretinal membrane with Candida chorioretinitis. Ophthalmology 97(4):466–469PubMedGoogle Scholar
  27. McDonald HR, Schatz H, Johnson RN et al (1996) Vitrectomy in eyes with peripheral retinal angioma associated with traction macular detachment. Ophthalmology 103(2):329–335PubMedGoogle Scholar
  28. Messmer EM, Heidenkummer HP, Kampik A (1998) Ultrastructure of epiretinal membranes associated with macular holes. Graefes Arch Clin Exp Ophthalmol 236(4):248–254PubMedCrossRefGoogle Scholar
  29. Meyer CH, Rodrigues EB, Mennel S et al (2004) Spontaneous ­separation of epiretinal membrane in young subjects: personal ­observations and review of the literature. Graefes Arch Clin Exp Ophthalmol 242(12):977–985PubMedCrossRefGoogle Scholar
  30. Michels RG (1981) Vitreous surgery for macular pucker. Am J Ophthalmol 92(5):628–639PubMedGoogle Scholar
  31. Michels RG (1984) Vitrectomy for macular pucker. Ophthalmology 91(11):1384–1388PubMedGoogle Scholar
  32. Michels RG, Gilbert HD (1979) Surgical management of macular pucker after retinal reattachment surgery. Am J Ophthalmol 88(5):925–929PubMedGoogle Scholar
  33. Park DW, Dugel PU, Garda J et al (2003) Macular pucker removal with and without internal limiting membrane peeling: pilot study. Ophthalmology 110(1):62–64PubMedCrossRefGoogle Scholar
  34. Sheard RM, Sethi C, Gregor Z (2003) Acute macular pucker. Ophthalmology 110(6):1178–1184PubMedCrossRefGoogle Scholar
  35. Smiddy WE, Michels RG, Gilbert HD, Green WR (1992) Clinicopathologic study of idiopathic macular pucker in children and young adults. Retina 12(3):232–236PubMedCrossRefGoogle Scholar
  36. Snead DR, Cullen N, James S et al (2004) Hyperconvolution of the inner limiting membrane in vitreomaculopathies. Graefes Arch Clin Exp Ophthalmol 242(10):853–862PubMedCrossRefGoogle Scholar
  37. Stalmans P, Feron EJ, Parys-Van GR et al (2003) Double vital staining using trypan blue and infracyanine green in macular pucker surgery. Br J Ophthalmol 87(6):713–716PubMedCrossRefGoogle Scholar
  38. Teba FA, Mohr A, Eckardt C et al (2003) Trypan blue staining in vitreoretinal surgery. Ophthalmology 110(12):2409–2412PubMedCrossRefGoogle Scholar
  39. Trese MT, Chandler DB, Machemer R (1983a) Macular pucker. I. Prognostic criteria. Graefes Arch Clin Exp Ophthalmol 221(1):12–15PubMedCrossRefGoogle Scholar
  40. Trese M, Chandler DB, Machemer R (1983b) Macular pucker. II. Ultrastructure. Graefes Arch Clin Exp Ophthalmol 221(1):16–26PubMedCrossRefGoogle Scholar
  41. Verbraeken H (1996) Therapeutic pars plana vitrectomy for chronic uveitis: a retrospective study of the long-term results. Graefes Arch Clin Exp Ophthalmol 234(5):288–293PubMedCrossRefGoogle Scholar
  42. Wilson DJ, Green WR (1987) Histopathologic study of the effect of retinal detachment surgery on 49 eyes obtained post mortem. Am J Ophthalmol 103(2):167–179PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Thomas H. Williamson
    • 1
  1. 1.Department of OphthalmologySt. Thomas’ HospitalLondonUK

Personalised recommendations