Macular Pucker

Diagnosis and Monitoring Macular Pucker

Macular pucker can be diagnosed by an ophthalmologist performing a retinal examination following pupil dilating drops. Its progress can be followed over time by measuring visual acuity, checking for distorted vision while looking at a graph called an Amsler grid, or by special photographs. These can include color photographs of the retinas, and important cross-section photos of the retina taken by a process called optical coherence tomography (OCT). The OCT shows the extent of retinal scar formation and retinal distortion caused by traction from the scar tissue.

Treatment: Non-Surgical Interventions Macular Pucker

Since most patients have only mild symptoms, they can best benefit from new glasses, reading lamps, and perhaps magnifiers. For patients with more severe symptoms, medical or surgical treatment may be appropriate. A subgroup of patients with macular pucker that is caused by the vitreous tugging on the macula (vitreomacular traction) may benefit with a single injection into the eye of a medication called Jetrea. This drug is an enzyme that digests the tiny fibers in the vitreous, potentially releasing the traction.

Treatment: Macular Pucker Surgery to Remove Scar Tissue

For patients who would not benefit from Jetrea, surgery may be helpful. The outpatient surgery is done with local anesthesia and involves removing the vitreous (vitrectomy) and usually peeling off the cellophane-like scar tissue. This can help relieve the retinal traction, decreasing distortion of the vision, and improving visual acuity.

Related Disorders

A related disease is the macular hole, which can result from traction on the retina, and can also require vitrectomy surgery to relieve the traction and close the hole. Another disease, retinal detachment, occurs when the retina separates from the back of the eye, usually caused by a tear in the peripheral retina resulting from the vitreous tugging on the retina as it separates. The symptoms of a retinal tear/detachment in one eye are:

• Arcs of flashing light in the peripheral vision;
• New floating black dots in the vision; or
• A curtain blocking the peripheral vision, which may enlarge to block the central vision.

Since a retinal tear is an emergency, patients with the symptoms of a retinal tear/detachment should call their ophthalmologist immediately to receive vision-protecting treatment if a tear or detachment is diagnosed.

Retinal Detachment Video