The aim of the current study was to determine the association between fundus fluorescein angiography (FFA) image results, optical coherence tomography (OCT) imaging results and visual functions in patients with idiopathic epiretinal membranes (ERMs). A total of 80 eyes from 40 patients diagnosed with ERM were analyzed. Best-corrected visual acuity (BCVA) and metamorphopsia were measured using the Early Treatment Diabetic Retinopathy Study eye chart and M-charts, respectively. Macular thickness and volume were determined using OCT. Macular vascular leakage and distortion, and foveal avascular zone (FAZ) diameters were assessed using FFA. BCVA and M-chart results confirmed macular degeneration in the affected eyes. The area of macular vascular leakage was positively correlated with macular volume (r=0.50; P=0.001). The ratio of FAZ diameters was negatively correlated with central macular thickness (r=-0.41; P=0.008). The grade of macular vascular distortion was positively correlated with macular thickness (all r=0.47; P<0.01) and volume (r=0.53; P<0.001). The results of the current study demonstrated that FFA may effectively identify the degree of changes in retinal macular vasculature. Vascular distortion, measured by FFA, may reflect changes in macular structure and visual functions. These results suggest a potential application of FFA in the pre-and post-surgical evaluation of patients with ERMs.