Spontaneous peeling of an epiretinal membrane in an eye with treated proliferative diabetic retinopathy

An epiretinal membrane (ERM) usually occurs in eyes that have had a posterior vitreous detachment (PVD). Primary causes are typically unknown, but several secondary causes are known, such as retinal vascular disease. The presence of an ERM can exert traction on the neurosensory retina and can also contribute to the development of cystoid macular edema (CME). Rare ERM cases have shown spontaneous separation from the inner retinal surface, often leading to improved visual symptoms. We present a diabetic patient with proliferative diabetic retinopathy treated with panretinal laser photocoagulation who developed a marked ERM. Over a 5 year period, there was liquefaction and separation of the posterior hyaloid along with progressive and spontaneous release of the ERM, leading to improved foveal contour. This case demonstrates the self-peeling of a secondary ERM following PVD formation in an eye with treated proliferative diabetic retinopathy.