By Vitreous Retina Macula Consultants of New York

03/13/2023 Macular pucker is a name given to a condition in which scar tissue grows in appropriately over the surface of the macula. This same condition has been called cellophane retinopathy, macular wrinkle, and epiretinal membrane. A jelly-like substance called the vitreous fills the central portion of the eye. It is composed of 99% water, some chemicals to create the gel, and long protein fibers. As we age the vitreous begins to shrink. The jelly starts to break down and the protein fibers start to aggregate.
In most people the vitreous eventually separates from the retina in a process called posterior vitreous detachment. In about 6% of people the detachment of the vitreous causes a wound healing response. The separation of the vitreous doesn’t seem like a traumatic event, but in some people their eye grows a fine layer of scar tissue over the macula, which is the portion of the retina in the back of the eye that has good visual acuity.
The scar tissue grows for a short period of time – usually a few weeks at most. Similar to what it does elsewhere in the body, scar tissue then begins to shrink. This causes the macula to wrinkle. If a thread in a piece of fabric is pulled the fabric will also wrinkle. This is how the term macular pucker was derived. The thin sheet of scar tissue is light gray and reflective, and when it gets wrinkled it looks like crumbled cellophane, thus the term cellophane maculopathy. The scar tissue can affect how the light rays course to the retina, the retina itself is crumbled by the scar tissue, and secondarily the macular may become swollen.
All of these factors cause the vision to become decreased and distorted. Chronic deformation of the macula by the scar tissue can cause cumulative damage, with slowly decreasing visual acuity in some patients. Fortunately in most patients the visual acuity generally remains stable.
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Vitreous Retina Macula Consultants of New York
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New York, NY 10013
(212) 234-3367
(212) 861-9797
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https://vrmny.com
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