Abstract
Purpose :
Metamorphopsia (MM) is a visual symptom which may affect a patient’s activities of daily living and potentially herald the onset of sight-threatening macular disease. To date, there is a lack of robust, large-scale prospective studies reporting the prevalence of MM and its impact on quality of life (QoL) in patients with vitreomacular traction (VMT). We performed a prospective, multi-centre, observational, cross-sectional study in the UK to assess the prevalence of MM and its impact on QoL.
Methods :
Between July 2014 and July 2015, 185 patients with a diagnosis of VMT, with or without macular hole (MH) in the last 6 months, were enrolled at 19 ophthalmology clinics in the UK. Data on patient demographics, medical history, ocular comorbidities, ocular interventions, retinal examination and OCT findings, and the physician’s assessment of ocular diagnosis in both the affected and fellow eye were collected. Patients completed 3 validated QoL questionnaires (NEI-VFQ-25, HUI-3, EQ5D). The presence and severity of MM was determined according to the patient’s self-reported perception, using a validated metamorphopsia questionnaire. Treating physicians assessed the presence of MM as per usual clinical practice. Differences between patient subgroups (MM vs. No MM; MH vs. no MH) were derived from chi-square and Student’s t-test for categorical and continuous variables, respectively. The impact of MM on QoL was adjusted for covariates using multivariable linear regression models.
Results :
The mean (±SD) age of the 185 patients enrolled in the study was 72.8 (±8.7) years with 124 females. The prevalence of patient reported MM was 69.7% in this cohort (129 patients). The mean MM questionnaire score was 0.63 and differed significantly between MH (0.66) and no MH (0.36) patients (P=0.001). All QoL scores indicated significantly poorer QoL in MM vs. no MM patients. Differences depending on the presence of MM remained significant after adjusting for demographics, ocular conditions, interventions, visual acuity, OCT measures, eye dominance and fellow-eye-involvement.
Conclusions :
This study shows that there is a high prevalence of MM in eyes with VMT, with a higher prevalence and severity in patients with concomitant MH. MM is associated with significantly lower QoL after adjusting for covariates including visual acuity.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.