Issues with macular pucker 14 years after successful retinal surgery

[cristina1676]

2006 successful retinal detachment surgery. I’ve dealt with macular pucker and edema. 2017 had successful cataract surgery. August 12 I noticed 2 areas in my central vision that lol like washed out =. Yes equal signs. I went to the dr 8/16 and again September 1. I have no floaters/flashers or veil/curtain in my sight. No squiggly lines and I’m fine reading. It’s as if someone erased a pet of the world. The dr says no macular degeneration or retinal tears or detachments. Has anyone else had this? I do an smaller grid every day and night. The lines are all there. The area of washed out tend to have a bluish color which I’m assuming is the way light hits the retina. I know I’ve asked this a while ago but I was curious if anyone else deals with this pucker/edema thing. It’s more distracting than anything. I see the dr again 12/2. I go every 3 months to my retina specialist. (I only have vision in this eye so macular pucker peel won’t be done unless I cannot function)

[cristina1676]

My optic nerve was fine as well. He’s being positive and hoping it will go away. The Prolensa I use obviously is working because the Edema is almost all gone.

[John C Hagan III, MD, FACS, FAAO]

Best of luck. Hopefully it goes away and not really important the cause if ceases to be a problem.

[cristina1676]

Update. December 2, 2020. I went to go see my retinal specialist and he said that everything looks stable. My macula shows no more inflammation but the pucker is still there. The scleral buckle is in place and fine. He cannot find any reason for me seeing what I’m seeing. He did mention that I have a new intraocular lens from my cataract surgery it could be picking up the pucker that I have. I saw 20/20 and my pressure was 14. Back in March.

[cristina1676]

I meant to say I do an Amsler grid every day. No distortion.

[John C Hagan III, MD, FACS, FAAO]

You could have mild symptoms like you observe but normal amsler.   Look at the OCTs so you know normal vs small ERM vs large ERM.  Ask for copy of yours and ask if your symptoms could be due to abnormal OCT due to small ERM  I have had very observant, perfectionist patients with similar observations.

[cristina1676]

Thank you so much. I really appreciate your answering me. I will let you know what happens on December 2. I try very hard to ignore it because it’s right off my central vision it’s very hard to. I’m just very thankful that I’m still able to read.

[John C Hagan III, MD, FACS, FAAO]

Best of all possible outcomes.  As a learning experience for the huge number of people that visit this site please do post a follow up. Thanks.

[cristina1676]

I absolutely will

[John C Hagan III, MD, FACS, FAAO]

=

[John C Hagan III, MD, FACS, FAAO]

Use your search engine and pull up OCT images of a normal macula, then pull up images of macula with various sizes of macular pucker,  this is also know more properly as epiretinal macular membrane (ERM).  See how it is a gradient between tiny membrane with little distortion to huge membranes that cause macular holes and huge surface distortion.   I suspect the abnormal areas you see are where the ERM is thickest.  Next time you see your retina specialist. ask for a color copy of your macular OCTs. Compare it with normal. Ask the retina specialist if the ERM might cause your observations. My feeling that is the cause.

[cristina1676]

Thank you. It’s been 14 years since my rd and this just happened 8/12. Can these membranes change shape meaning now after all this time? You’re such a good man for answering. You’ve answered so many of my questions.

[John C Hagan III, MD, FACS, FAAO]

Yes ERM have to be monitored indefinitely as they often grow larger over time causing more distortion, symptoms, and worse case a full thickness macular hold. Your symptoms and ERM are far to mild to justify surgery.

[cristina1676]

Let me clarify it is not a black out or grey area. It’s almost like someone took a picture and the after flash is there. It doesn’t move or float around d.