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masahiko hasumi, Fumiki Okamoto, Yoshimi Sugiura, Yoshifumi Okamoto, Tetsuro Oshika; Relationship Between Metamorphopsia and Foveal Microstructure after Rhegmatogenous Retinal Detachment Surgery. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1078.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the relationship between metamorphopsia and morphologic changes in the macular region after successful repair of rhegmatogenous retinal detachment.
The study included 129 eyes of 129 patients who had undergone successful retinal reattachment surgery. The severity of metamorphopsia was recorded with the M-CHARTS and foveal microstructures were assessed with spectral-domain optical coherence tomography (OCT) at 6-12 months postoperatively.
The mean metamorphopsia score was 0.30 ± 0.46, with 50 of 129 patients having metamorphopsia (metamorphopsia score ≥ 0.2). Metamorphopsia was severer in eyes with macula-off RD than those with macular-on RD (p < 0.001). Eighteen of 50 eyes with metamorphopsia exhibited abnormal structures in the macular region (epiretinal membrane, disruption of the photoreceptor inner and outer segment junction, cystoid macular edema, macular hole or subretinal fluid), whereas other 32 eyes showed no morphologic changes with OCT. In these 32 eyes, the horizontal metamorphopsia score (0.86 ± 0.50) was significantly higher than the vertical metamorphopsia score (0.62 ± 0.39, p < 0.05). Of 9 eyes with macula-on RD and postoperative metamorphopsia, 6 showed abnormal macular structures and other 3 presented normal findings. The macula briefly detached during vitrectomy in these 3 cases.
After successful RD repair, 39% of patients developed metamorphopsia at 6-12 month postoperatively. OCT imaging, however, indicated that more than half of eyes with metamorphopsic had normal macula structures. Our results suggested that retinal vertical displacement after surgery might mainly induce horizontal metamorphopsia. Pre- and intraoperative macula-on RD did not appear to induce metamorphopsia postoperatively.
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