Abstract
Vitreous anteroposterior traction is an important factor that affects macular hole (MH) formation at the early stage, and vitreous tangential traction can lead to further hole expansion after hole formation. Recent studies have highlighted the significance of Müller cells for the pathogenesis of MH. Since the advent of MH treatment, success rates for MH closure have significantly improved, as has postoperative visual acuity. However, metamorphopsia, an initial and common symptom of MH, still exists. Metamorphopsia is significantly related to the deterioration of visual quality of life and can be used as an independent index to evaluate visual function before and after surgery. In MH patients, metamorphopsia has different manifestations representing different clinical implications. M-CHARTS, as a new means of inspection, can quantify the degrees of metamorphopsia, and with the development of optical coherence tomography (OCT), layer-by-layer scanning of the retinal structure has become possible. These methods enable detailed analysis of the connections between the degree of metamorphopsia and relevant OCT parameters. Preoperative OCT parameters can be used to evaluate the prognosis of the postoperative visual function of MH patients and are therefore of great significance in guiding the treatment of MH patients.
Highlights
Idiopathic macular hole (IMH), as a kind of common macular diseases, involves tissue defects including the retinal internal limiting membrane (ILM) and even the photoreceptor (PR) layer [1], and it is known that vitreous traction on local retina, posterior vitreous detachment (PVD) around the macular fovea, and continuous adhesion are major etiological factors in most IMH cases [1,2,3,4]
Tangential traction is formed when the residual vitreous remains on the fovea after the PVD contracts [12], during which Muller cells proliferate and invade the ILM
Visual function affects a patient’s visual quality of life and is not limited to postoperative visual acuity; postoperative improvement in metamorphopsia is important. rough an in-depth study of the pathogenesis of MH and metamorphopsia, we conclude that metamorphopsia in MH is the result of tangential centrifugal displacement of the PR cell layer
Summary
Idiopathic macular hole (IMH), as a kind of common macular diseases, involves tissue defects including the retinal internal limiting membrane (ILM) and even the photoreceptor (PR) layer [1], and it is known that vitreous traction on local retina, posterior vitreous detachment (PVD) around the macular fovea, and continuous adhesion are major etiological factors in most IMH cases [1,2,3,4]. E main clinical manifestations of IMH include decreased vision, metamorphopsia, and central dark spots, which can occur suddenly or gradually. It is necessary to explore the related research of metamorphopsia. In this way, the study metamorphopsia of macular holes can be fully understood
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