An idiopathic epiretinal membrane is a syndrome associating a macular oedema, a reactive astrocytic gliosis and an adherent plaque of posterior hyaloid. The astrocytic proliferation enters the hyaloid fibres so that the typical reflection can appear. When there is no adherent plaque of hyaloid, an aspect of pure oedema is observed.

ILM removal has two functions:

  1. It removes the hyaloid fibres entirely and therefore treats the retraction syndrome
  2. It removes the Müller cell end-feet and thereby induces Müller cell gliosis. The Müller cell expression of GFAP has neurotrophic action, fights against the blood retina barrier breakdown and has synaptogenesis properties.