Abstract
Purpose :
Quality of vision in patients with idiopathic epiretinal membranes (iERM) is highly dependent on the degree of metamorphopsia, an often overlooked symptom. The degree of metamorphopsia after vitrectomy with membrane peeling is difficult to predict and quantification of metamorphopsia may be helpful to identify patients that may benefit most from surgery. This study evaluated the applicability of a novel smartphone-based hyperacuity test (SHT) compared to a conventional printed chart for metamorphopsia quantification before and after iERM surgery. Since the software used, an FDA 510(k) cleared device for macular disease, has never been investigated for the indication of iERM, the study was designed as a pilot study.
Methods :
This pilot study prospectively included 30 iERM patients with symptomatic metamorphopsia detected on the Amsler grid scheduled for vitrectomy with membrane peeling. The SHT (Alleye, Oculocare medical Inc., Zurich, Switzerland) as well as the horizontal (MH) and vertical (MV) M-chart (Inami & Co., Ltd., Tokyo, Japan) tests were consecutively performed three times before and three months after surgery. The main outcome variables were the pre- and postoperative mean of the SHT (SHT score), MH score, MV score and the sum of MH and MV (MH+MV score).
Results :
In total, 27 patients were included into the analysis. The pre- and postoperative SHT scores showed weak, but insignificant correlations with the MH (r=-0.180/ p=0.369; r=-0.142/ p=0.481), MV (r=-0.007/ p=0.973; r=-0.198/ p=0.322), and MH+MV scores (r=-0.132/ p=0.512; r=-0.179/ p=0.370). The mean SHT score significantly improved from 55.2 ± 18.9 before surgery to 63.5 ± 16.3 after surgery (r=0.686/ p<0.001) while the improvement of the M-chart scores were insignificant (MH r=0.368/ p=0.059; MV r=0.182/ p=0.363).
Conclusions :
The poor correlation between the metamorphopsia scores of the smartphone-based hyperacuity test and the M-chart may be explained by the discrepancy between the examined retinal axes. The significant improvement of the SHT score suggests that patients with metamorphopsia due to an iERM may benefit from surgery and this application may potentially be a software to quantify metamorphopsia in iERM patients. Further studies including the patient's subjective perception of metamorphopsia as well as a larger sample size and longer follow-up period are required to validate these results.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.