What is a macular fold: symptoms, causes and treatments

When there is a macular wrinkle, there may be no symptoms. At other times, distortions occur in visual perception. Read on and we’ll tell you more.

Last update: 15 October, 2022

A macular fold is an extra tissue formation in the center of the retina. It is not a very common condition. Sometimes it presents with mild symptoms. But other times, it can affect vision.

The cause is not always known, although it is associated with age-related degeneration. Most patients do not require treatment, unless the person finds it difficult to carry out their activities.

What is a macular wrinkle?

At its back, the eye has the retina. In particular, in the center of this is the macula, which is made up of special cells that react to light.

Now, there are different conditions that can affect this area of ​​the eye, reducing our ability to perceive images. These include macular hole, macular edema, and age-related macular degeneration.

On the other hand, cells inside the eye can grow. This causes the fabric to wrinkle, contract, or become tight.appearing a sheet in the form of a healing membrane or forming a protuberance.

This is called pucker either macular fold. It is also known by other names:

  • Epiretinal or preretinal membrane.
  • Cellophane retinopathy.
  • Wrinkles in the retina.


In some people there are no symptoms. In other cases, they are rather mild, and do not cause significant vision loss.

Although there may also be a distorted perception, making it difficult to carry out daily activities. Among the most frequent symptoms of the macular fold the following are mentioned:

  • Central vision is blurred.
  • Difficulty reading small letters.
  • There may be difficulty perceiving details.
  • Objects appear wavy, even straight lines.
  • Sometimes a gray or cloudy area, even empty, is noticed as a blind spot.

The macular pucker does not affect peripheral vision.

The retina is a thin layer of cells. The fundus, for example, is a method of viewing that section of the anatomy.

Causes of macular wrinkling

Most of the time, the cause is not known. Among those that have been identified, the following are mentioned:

  • Aging: Over time, the vitreous humor of the eye can compact, separating from the retina. It may also stick together, causing scar tissue to form.
  • An injury or illness: like diabetes.
  • Surgical intervention: retinal surgery or a cataract operation.
  • Other causes: retinal tear or detachment, blood supply problems in the area.

There are also risk factors that increase the risk of macular puckering. In this regard, the inflammations inside the eye and the uveitis.

How do you make the diagnostic?

For the diagnostic, the ophthalmologist will place a few drops, so that the pupil dilates. This will allow you to see inside, using a device called ophthalmoscope.

If a macular pucker is suspected, an optical coherence tomography (OCT) can be done, which scans the back of the eye, providing detailed images of the retina and the macula.

treatment options

In most cases, there are no symptoms or they are mild, so no treatment is required if vision is not affected. But there are situations where glasses may be prescribed. It may also happen that the person who already wears optical correction needs to modify it.

Surgery is only recommended in some cases, when the symptoms are more severe or disabling. In this regard, there are two possibilities:

  • Vitrectomy: in this surgery, part of the vitreous humor and scar tissue is removed. It is an outpatient process, which seeks to reduce or flatten the macula. It is recommended when the cause is related to basic surgical procedures.
  • Membranectomy: In this surgery, the retinal membrane is removed. It can also be done on an outpatient basis. This procedure is the usual one in the unwanted consequences of cataract surgery or after uveitis.

Risks of surgeries

With surgery, vision may improve in some cases, but it will not be as good as it was before the fold developed. However, there are people who do not experience such improvement after the intervention.

Also, as with any surgery, Vitrectomy as well as membranectomy carry risks. Among these are the following:

  • Waterfalls.
  • infections.
  • Hemorrhage.
  • Retinal detachment.
Eye surgeries for macular puckering are reserved for severely ill patients who have vision loss.

Can macular wrinkling be prevented?

Taking into account that the cause is not known in all cases, it is not always possible to prevent or even prevent the appearance of a macular fold. Nevertheless, precautions need to be taken in people with diabetes or who have had retinal detachment. Also those who have undergone cataract operations.

Similarly, since age is one of the associated factors, it is important to visit the ophthalmologist regularly for eye exams. Whether you suffer from macular puckering, to make sure it doesn’t get worse, or for early diagnosis.

It is easier to treat a new macular fold than one that is old. It is also possible that in some cases the problem starts in one eye and then affects the other.

A macular fold can grow back after removal, although this is not the most common.

When to go to the doctor?

Often, we experience some phenomena in the vision, such as momentary lights. If we go from a light place to a dark place, we may not see well.

If blurred vision problems, distortions, difficulty focusing what is in front of us, then it is better to go to the ophthalmologist. When a macular fold is detected, there is no need to be alarmed.

As usual, no treatment will be needed if symptoms are mild. And whether it is this problem or not, it must not be allowed to advance.

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