Abstract
Purpose :
Surgery for rhegmatogenous retinal detachment with macular involvement (RRDMI) has a high success rate, but postoperative visual function varies. Metamorphopsia and aniseikonia are known postoperative complaints, though previous studies into the incidence of these complaints are variable in results. We performed a prospective observational study to quantify postoperative metamorphopsia and aniseikonia after anatomically successful surgery for RRDMI and to correlate these variables with postoperative best corrected visual acuity (BCVA).
Methods :
For this study we included 40 patients who had successful surgery for unilateral RRDMI. Both eyes, RRDMI eye and fellow eye, were assessed 6 months postoperatively. BCVA was measured using ETDRS chart. Metamorphopsia was subjectively scored as present or absent and aniseikonia was subjectively scored as absent, micropsia or macropsia. In 15 patients, metamorphopsia and aniseikonia were quantified in horizontal and vertical direction using M-CHARTS and New Aniseikonia Test.
Wilcoxon signed-rank test and chi-square test were used to evaluate differences between RRDMI and fellow eye. Correlations between the degree of metamorphopsia and aniseikonia with BCVA were evaluated by Spearman's correlation coefficient.
Results :
Six months after surgery, BCVA between RRDMI eyes (0.13 ± 0.30 LogMAR)(median ± IQR) and fellow eyes (-0.06 ± 0.10 LogMAR) differed significantly (p <0.001). Metamorphopsia was more often reported in RRDMI eyes (87.5%) than in fellow eyes (0%) (p<0.001). Aniseikonia was reported as micropsia in 28 patients (70%), absent in 12 patients (30%) and never as macropsia.
Horizontal and vertical metamorphopsia were 1.13 ± 0.71° (mean ± SD) and 0.89 ± 0.57°. Horizontal and vertical aniseikonia were -1.0 ± 6.0% (median ± IQR) and -1.0 ± 2.0%. BCVA was neither correlated with the degree of metamorphopsia nor with the degree of aniseikonia.
Conclusions :
Despite successful surgery for RRDMI, a large majority of patients experience metamorphopsia (87.5%) and micropsia (70.0%). As the severity of metamorphopsia and aniseikonia shows no correlation to BCVA, merely measuring BCVA seems inadequate for an assessment of visual function.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.