Epiretinal membranous tissue in retinal detachment due to macular holes in highly myopic eyes

Abstract Objective : To determine the frequency of occurrence of epiretinal membranous tissue in retinal detachment due to macular hole and to evaluate the efficacy of vitreous surgery including removal of the membrane. Design : Noncomparative case series. Participants : Eighteen highly myopic eyes with retinal detachment due to macular holes. Results : Epiretinal membranous tissue was removed from 7 eyes (39%) and retinal reattachment was obtained in 14 eyes (78%) after the initial vitreous surgery. Of 4 eyes that required reoperation, 2 eyes achieved reattachment after a long term of internal tamponade. Histological examination of an epiretinal membrane from one case revealed that it was composed of glial cells, connective tissue, and fragments of inner limiting membrane. An intraoperative use of autologous serum as a tissue adhesive for macular holes had no effect on surgical success. Conclusion : The first therapeutic choice for this disease should be vitreous surgery with removal of the epiretinal membrane when practical, though the membrane cannot always be identified in every case.