Good Hope, Heartlands, and Solihull Eye Clinics

Case 22 epiretinal membranes (ERM) and Adult Bests

David Kinshuck



  • 1922 date of birth, female
  • 2000 poor vision left eye..epiretinal membrane noted 6/36
  • 2010 these photos/scan. reduced vision right eye 6/18, left 6/36
  • 'Adult Bests', previously termed 'Adult onset foveomacular vitelliform dystrophy' ,
  • ERM= epiretinal membrane
  • PED= pigment epithelial detachment

The left eye is stable, no treatment would improve the vision. The findings show an epiretinal membrane, with a large 'drusen' at the fovea. The foveal changes sow an early drusenoid PED, usually part of Adult Bests disease.   As the sight has not changed in 10 years, it should remain at this level in future.
The right eye shows a similar combination of epiretinal membrane (ERM) and a drusenoid PED (pigment epithelial detachment), a feature of Adult Bests'  disease. The sight in this eye has deteriorated in the last year, and it is difficult to decide whether this is because of the drusenoid PED or the ERM. There is no treatment for Adult Bests..this may get slowly slightly worse. But the ERM might progress, and colleagues wondered whether ERM removal would be helpful.


epiretinal membrane, bilateral. and right drusenoid PED

Top photo and scan

Epiretinal membrane (ERM) and 'Adult Bests' (a large white drusenoid PED at the fovea).


Bottom photo and scan
Epiretinal membrane (ERM) and Adult Bests
(the drusenoid PED is revealed by the scan, not really visible on the photograph).