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Hirofumi Morita, Hiroyuki Kondo; Metamorphopsia after vitrectomy for macula-off rhegmatogenous retinal detachment.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1084.
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© ARVO (1962-2015); The Authors (2016-present)
To quantify the degree of metamorphopsia in patients after successful vitrectomy for macula-off rhegmatogenous retinal detachment (RRD).
Twenty-four eyes of 24 patients whose fovea was reattached and regained normal morphology by optical coherence tomography (OCT) were studied. Eyes with an epiretinal membrane or distorted foveal morphology by OCT were excluded. The degree of metamorphopsia was determined by the M-CHARTS. Metamorphopsia scores for vertical (MV) and horizontal (MH) lines were compared. M-CHARTS scores and best-corrected visual acuity (BCVA) at 3, 6 and 12 months after surgery were measured. Factors affecting the metamorphopsia score including the age and presumed duration of the macular detachment were also evaluated.
Eighteen of 23 patients (78.3%) had a mean metamorphopsia score (MV+MH)/2 of ≧ 0.2 at 3 months after surgery. The average MV scores at 3, 6, and 12 months after surgery were 0.60, 0.53, and 0.40 respectively, and the MH scores at 3, 6 and 12 months after surgery were 0.37, 0.47 and 0.37, respectively. The MV at 3 month was significantly better than that at 12 months. The MV score was significantly larger than the MH score at 3 months. The duration of the macular detachment was from 1 to 10 (median 4) days, and it was significantly correlated with the difference of MV and MH (MV - MH) scores at 3 months. There was no significant correlation between the postoperative BCVA and the metamorphopsia scores at 3, 6, and 12 months postoperatively.
Clinically significant degree of metamorphopsia was present in 78.3% of the patients even if the fovea was reattached anatomically. The metamorphopsia tended to decrease up to 6 months. The greater MV than MH score indicates that the vertical properties of the reattached retina are more influenced by vitrectomy than the horizontal properties.
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