Spontaneous epiretinal membrane (ERM) release is a rare phenomenon observed in approximately 3% of patients with idiopathic ERM, with a prevalence reaching 13–27% in specific patient subgroups. Although the pathophysiological mechanisms are not fully elucidated, posterior vitreous detachment and contractile forces within the membrane itself are considered key factors leading to its spontaneous release from the retinal surface. Modern optical coherence tomography studies reveal two primary mechanisms of spontaneous release: via vitreomacular traction in the presence of posterior vitreous detachment, and through self-contraction and shrinking of the membrane in the absence of vitreous traction. Visual outcomes following spontaneous ERM release are favorable in most cases, characterized by improved visual acuity, reduced metamorphopsia, and a decrease in retinal contraction. Prognostic factors for better visual outcomes include preserved integrity of the photoreceptor layer and the absence of cystoid intraretinal changes. This article reviews current literature on the prevalence, mechanisms, imaging characteristics, and visual outcomes associated with spontaneous ERM release. We also present a clinical case of spontaneous ERM release occurring immediately after fluorescein angiography, illustrating the potential role of mechanical factors in this process.
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