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Tomoya Murakami, Fumiki Okamoto, Yoshimi Sugiura, Yoshifumi Okamoto, Takahiro Hiraoka, Tetsuro Oshika; Time course of changes in metamorphopsia and retinal microstructure after successful rhegmatogenous retinal detachment surgery. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1029. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the time course of changes in metamorphopsia after rhegmatogenous retinal detachment (RD) surgery and to evaluate the relationship between metamorphopsia and retinal microstructure by spectral-domain optical coherence tomography (OCT).
The study included 47 eyes of 47 patients undergoing RD surgery. We examined the severity of metamorphopsia using M-CHARTS, best-corrected visual acuity (BCVA) and OCT images before and at 3, 6 and 12 months after surgery. Based on the obtained OCT images, we quantified the following parameters using an image-processing program: central foveal thickness (CFT), thickness of the henle fiber layer and outer retinal layer (HFL+ONL), thickness of external limiting membrane-retinal pigment epithelium (ELM-RPE). The status of external limiting membrane (ELM), ellipsoid zone (EZ) and interdigitation zone (IZ) was also evaluated. Circumferential dimension of retinal tears, area of RD and macula status (on or off) were assessed prior to surgery.
Metamorphopsia score at 12 months was 0.31 ± 0.38, with 26 of 47 patients (55%) having metamorphopsia (metamorphopsia score ≥ 0.2). Metamorphopsia score at 12 months was significantly related to preoperative BCVA (r = 0.536, p < 0.05) and BCVA at 12 months (r = 0.403, p < 0.05). Area of RD and macula status were significantly associated with metamorphopsia score at 12 months (p < 0.05 and p < 0.01, respectively) and BCVA (p < 0.05 and p < 0.05, respectively) at 12 months. Multiple regression analysis revealed that metamorphopsia score at 12 months was significantly related to macula status (p < 0.005). In macula-off RD group, metamorphopsia score significantly related to disruption of interdigitation zone (p < 0.05) postoperatively. Improvement of metamorphopsia score was associated with increase of ELM-RPE thickness, but not with CFT, thickness of HFL+ONL, status of ELM, EZ and IZ.
After successful RD surgery, nearly half of patients had metamorphopsia. Metamorphopsia was severer in eyes with macula-off RD. The increase of ELM-RPE thickness was related to metamorphopsia in macula-off RD patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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