Abstract

PurposeTo evaluate postoperative metamorphopsia in macula-off rhegmatogenous retinal detachment (RRD) and its association with visual function, vision related quality of life, and optical coherence tomography (OCT) findings.Methods45 patients with primary macula-off RRD were included. At 12 months postoperatively, data on metamorphopsia using sine amsler charts (SAC), best corrected visual acuity (BCVA), letter contrast sensitivity, color vision (saturated and desaturated color confusion indexes), critical print size, reading acuity, the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), and OCT, were obtained.ResultsMetamorphopsia was present in 39 patients (88.6%), with most of them (n = 35, 77.8%) showing only mild metamorphopsia (SAC score = 1). Patients with metamorphopsia had significantly worse postoperative BCVA (p = 0.02), critical print size (p<0.0005), and reading acuity (p = 0.001) compared to patients without metamorphopsia. Other visual function outcomes and NEI-VFQ-25 overall composite score were all also somewhat lower in patients with metamorphopsia, but this did not reach statistical significance. No association with OCT findings was present.ConclusionThe prevalence of postoperative metamorphopsia in macula-off RRD patients is high, however, the degree of metamorphopsia is relatively low. When metamorphopsia is present, visual functions seem to be compromised, while vision related quality of life is only mildly affected.

Highlights

  • The incidence of rhegmatogenous retinal detachment (RRD) is around 20 cases per 100,000 person-years

  • Metamorphopsia was present in 39 patients (88.6%), with most of them (n = 35, 77.8%) showing only mild metamorphopsia (SAC score = 1)

  • It has been suggested that metamorphopsia may occur due to microstructural photoreceptor disruption that may be undetected by spectral domain optical coherence tomography (OCT) examination.[5]

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Summary

Introduction

The incidence of rhegmatogenous retinal detachment (RRD) is around 20 cases per 100,000 person-years. The pathogenesis of postoperative metamorphopsia remains controversial. Most likely, it is caused by disturbances in normal retinal anatomy due to poor orientation of photoreceptors after surgery. It is caused by disturbances in normal retinal anatomy due to poor orientation of photoreceptors after surgery Studies on both postoperative metamorphopsia and optical coherence tomography (OCT) have revealed associations between metamorphopsia and the presence of an epiretinal membrane (ERM)[3] and/or subretinal fluid.[3,4] OCT findings in patients with postoperative metamorphopsia are often normal.[3,4] In these cases, it has been suggested that metamorphopsia may occur due to microstructural photoreceptor disruption that may be undetected by spectral domain OCT examination.[5]

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