Cellophane maculopathy and macular degeneration refer to degenerative growth beneath the macula, which is an oval-shaped spot near the centre of the retina associated with highly accurate vision. In extreme cases of retinal growth, surgery can stop or slow the progress of macular degeneration to prevent total blindness.
Cellophane maculopathy is the development of a fine, glistening membrane on the surface of the retina. These growths may result in profound vision loss by covering, distorting or detaching the fovea centralis in the centre of the retina. In younger patients, these membranes may develop without symptoms in otherwise normal eyes with normal vision. When these growths are thick and contracted, the condition is called macular pucker. Most cases occur concurrently with retinal holes, ocular concussions, retinal inflammation or after ocular surgery.
The causes of cellular maculopathy may be idiopathic, arising spontaneously from ageing or diabetic scarring which mainly occurs in elderly patients. Other causes include retinal procedures such as retinal detachment surgery, photocoagulation and cryotherapy. Cellular maculopathy may also be caused by vascular disorders including vein occlusion and diabetes mellitus or by intraocular inflammation. In most cases, cellular maculopathy develops in eyes with no prior history of visual or medical problems.
Most membranes that grow on the surface of the retina are mild and will have little or no impact on vision. In cases with pronounced growth, the membrane may cause distortion in the macula area of the retina, which leads to blurred vision that will worsen over time. These growths and membranes typically do not cause complete blindness and generally impact the centre of vision, leaving peripheral vision unimpaired.
Treatment and Surgery
Some patients with cellophane maculopathy will show no symptoms; in such cases no treatment is needed aside from observation. However, for patients with reduced vision, the only effective treatments are vitrectomy and membrane peel surgery. Using a light pipe, a clear fluid infusion line and a vitreous cutter and aspirator roughly the size of a ballpoint pen ink refill, the vitreous layer and diabetic scar tissue is removed while the eye is kept inflated by liquid. This operation is very difficult, and results vary. The best results are achieved when the patient's vision is better than 6/18 before surgery (20/20 is normal vision).
Recovery after surgery can take up to three months. Patients wear an eye patch until the morning after surgery, and follow with eye drops applied several times per day for two to three weeks. Most patients can resume usual non-strenuous physical activity, but the ability to perform more complicated functions such as work, driving and other complicated visual tasks will vary.