Isolated Central Epiretinal Membrane: A Rare Complication of Fovea-Sparing Internal Limiting Membrane Peeling Technique

Figure 2

Example of the isolated central epiretinal membrane (ERM) development after fovea-sparing internal limiting membrane (ILM) peeling technique in a case with proliferative diabetic retinopathy with a fovea cyst (case 5). (A) A 39-year-old male patient had proliferative diabetic retinopathy and a fovea cyst with very thin fovea tissue. He received vitrectomy due to persistent macular edema despite several antivascular endothelial growth factor injections. During vitrectomy, concerning the very thin fovea tissue, we performed fovea-sparing ILM peeling to prevent inadvertent avulsion of fovea tissue. However, after the surgery, optical coherence tomography (OCT) showed the development of isolated central ERM formation with progression 1 month (B) and 3 months (C) later. The central fovea thickness (CFT) was 569 µm, and his visual acuity deteriorated to 20/400. We arranged second surgery to remove the central ERM and residual fovea ILM. (D) After second surgery, OCT showed improvement in fovea contour. Three months after the revision surgery, the CFT improved to 440 µm, and his visual acuity was 20/100.