Correlation between metamorphopsia and foveal microstructure changes in patients with rhegmatogenous retinal detachment after vitrectomy_Chinese Journal of Ocular Fundus Diseases

Authors：

Fu Yan ,  Zhang Yueling , Gu Zhaohui , Zhang Haijiang , Wang Liying , Geng Renfei

Department of Ophthalmology, Baoding First Central Hospital of Hebei Province, Baoding 071000, China;

Corresponding author：

Zhang Yueling, Email: 490409241@qq.com

Keywords：

Retinal detachment; Vision disorders; Macula lutea; Tomography, optical coherence; Vitrectomy

DOI：

10.3760/cma.j.cn511434-20200819-00395

Video：

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Objective To evaluate the changes of metamorphopsia in patients with rhegmatogenous retinal detachment (RRD) who underwent primary vitrectomy and to analyze the correlation between macular microstructure changes and metamorphopsia.Methods It was a retrospective clinical study. From January 2017 to January 2019, 57 patients (57 eyes) with RRD were examined and diagnosed in the Department of Ophthalmology of Baoding First Central Hospital were enrolled in this study. All patients underwent 23G PPV. All patients had retinal anatomical reduction after the first PPV. The best corrected visual acuity (BCVA), intraocular pressure, slit-lamp microscope, indirect ophthalmoscope, changes of metamorphopsia, and optical coherence tomography (OCT) were examined before PPV and 1, 6, 12 months after the operation. The BCVA examination was performed using the international standard visual acuity chart, which was converted into a logarithm of the minimum angle of resolution (logMAR) BCVA for the record. The macular fovea retinal thickness (CRT) was measured by Carl Zeiss Cirrus HD-OCT5000 instrument from Carl Zeiss Company, Germany, and the microstructural changes in the macular area were recorded, including the presence of the anterior macular membrane (ERM), cystic macular edema (CME), subretinal fluid (SRF), and the integrity of the ellipsoid zone (EZ) and outer membrane (ELM). The value of metamorphopsia (M value) was measured by the M-Chart table. The changes of BCVA, M value, and the microstructure of the macular area before and after operation were analyzed. The correlation between BCVA and M value was analyzed by Pearson correlation. Spearman correlation analysis was used to analyze the correlation between the changes of macular microstructure and BCVA and M values.Results The mean logMAR BCVA before the operation was 1.15±0.43. At 1, 6, and 12 months after the operation, the mean logMAR BCVA was 0.62±0.17, 0.39±0.18, and 0.34±0.13, respectively. The visual acuity improved significantly after operation compared with before operation, and the difference was statistically significant (F=119.731, P=0.000). The mean CRT before the operation was 476.0±104.1 μm. At 1, 6, and 12 months after the operation, the average CRT were 299.8±29.9, 272.2±17.8, and 261.0±19.3 μm, respectively. The average CRT after the operation was significantly lower than those before the operation (F=185.518, P=0.000). At 1, 6, and 12 months after the operation, the mean M values were 0.62±0.54, 0.43±0.41, and 0.32±0.36, respectively; the difference was statistically significant (F=6.568, P=0.020). After the operation, 48 eyes (84.2%, 48/57) had microstructural abnormalities in the macular area, including EZ and ELM integrity disruption, SRF, CME, and ERM. Correlation analysis showed that M value was significantly positively correlated with BCVA, CRT, and SRF height before operation (r/rs=0.672, 0.385, 0.932; P＜0.05). There was no correlation between M value and BCVA (r/rs=0.503), EZ and ELM integrity (r/rs=0.497, 0.472), SRF (r/rs=0.416), CME (r/rs=0.821) and ERM (r/rs=0.632) after operation (P＞0.05).Conclusions The BCVA is significantly increased and the metamorphopsia is improved after anatomically successful RRD surgery. Postoperative M value is highly correlated with preoperative BCVA, CRT, and SRF.

Citation： Fu Yan, Zhang Yueling, Gu Zhaohui, Zhang Haijiang, Wang Liying, Geng Renfei. Correlation between metamorphopsia and foveal microstructure changes in patients with rhegmatogenous retinal detachment after vitrectomy. Chinese Journal of Ocular Fundus Diseases, 2021, 37(4): 262-266. doi: 10.3760/cma.j.cn511434-20200819-00395 Copy

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5.	Wang Y, Li SY, Zhu M, et al. Metamorphopsia after successful retinal detachment surgery: an optical coherence tomography study[J]. Acta Ophthalmol Scand, 2005, 83(2): 168-171. DOI: 10.1111/j.1600-0420.2005.00413.x.
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8.	Okuda T, Higashide T, Sugiyama K. Metamorphopsia and outer retinal morphologic changes after successful vitrectomy surgery for macula-off rhegmatogenous retinal detachment[J]. Retina, 2018, 38(1): 148-154. DOI: 10.1097/IAE.0000000000001510.
9.	Poulsen CD, Petersen MP, Green A, et al. Fundus autofluorescence and spectral domain optical coherence tomography as predictors for long-term functional outcome in rhegmatogenous retinal detachment[J]. Graefe's Arch Clin Exp Ophthalmol, 2019, 257(4): 715-723. DOI: 10.1007/s00417-018-04222-w.
10.	Hirata N, Iwase T, Kobayashi M, et al. Correlation between preoperative factors and final visual acuity after successful rhegmatogenous retinal reattachment [J/OL]. Sci Rep, 2019, 9(1): 3217 [2019-03-01]. https://doi.org/10.1038/s41598-019-39839-2. DOI: 10.1038/s41598-019-39839-2.
11.	Murakami T, Okamoto F, Sugiura Y, et al. Changes in metamorphopsia and optical coherence tomography findings after successful retinal detachment surgery[J]. Retina, 2018, 38(4): 684-691. DOI: 10.1097/IAE.0000000000001588.
12.	Rossetti A, Doro D, Manfre A, et al. Long-term follow-up with optical coherence tomography and microperimetry in eyes with metamorphopsia after macula-off retinal detachment repair[J]. Eye (Lond), 2010, 24(12): 1808-1813. DOI: 10.1038/eye.2010.138.
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14.	Lee E, Williamson TH, Hysi P, et al. Macular displacement following rhegmatogenous retinal detachment repair[J]. Br J Ophthalmol, 2013, 97(10): 1297-1302. DOI: 10.1136/bjophthalmol-2013-303637.
15.	Bae SH, Kim D, Park TK, et al. Preferential hyperacuity perimeter and prognostic factors for metamorphopsia after idiopathic epiretinal membrane surgery[J]. Am J Ophthalmol, 2013, 155(1): 109-117. DOI: 10.1016/j.ajo.2012.07.007.

1. Okamoto F, Sugiura Y, Okamoto Y, et al. Metamorphopsia and optical coherence tomography findings after rhegmatogenous retinal detachment surgery[J]. Am J Ophthalmol, 2014, 157(1): 214-220. DOI: 10.1016/j.ajo.2013.08.007.
2. Shiragami C, Shiraga F, Yamaji H, et al. Unintentional displacement of the retina after standard vitrectomy for rhegmatogenous retinal detachment[J]. Ophthalmology, 2010, 117(1): 86-92. DOI: 10.1016/j.ophtha.2009.06.025.
3. van de Put MA, Vehof J, Hooymans JM, et al. Postoperative metamorphopsia in macula-off rhegmatogenous retinal detachment: associations with visual function, vision related quality of life, and optical coherence tomography findings [J/OL]. PLoS One, 2015, 10(4): e0120543[2015-04- 08]. https://doi.org/10.1371/journal.pone.0120543. DOI: 10.1371/journal.pone.0120543.
4. Schawkat M, Valmaggia C, Lang C, et al. Multimodal imaging for detecting metamorphopsia after successful retinal detachment repair[J]. Graefe's Arch Clin Exp Ophthalmol, 2020, 258(1): 57-61. DOI: 10.1007/s00417-019-04498-6.
5. Wang Y, Li SY, Zhu M, et al. Metamorphopsia after successful retinal detachment surgery: an optical coherence tomography study[J]. Acta Ophthalmol Scand, 2005, 83(2): 168-171. DOI: 10.1111/j.1600-0420.2005.00413.x.
6. Kalinowska A, Nowomiejska K, Brzozowska A, et al. Metamorphopsia score and central visual field outcomes in diabetic cystoid macular edema [J/OL]. Biomed Res Int, 2018, 2018: 4954532[2018-03-18]. https://doi.org/10.1155/2018/4954532. DOI: 10.1155/2018/4954532.
7. Coppol M, Marchese A, CicinelliI MV, et al. Macular optical coherence tomography findings after vitreoretinal surgery for rhegmatogenous retinal detachment[J]. Eur J Ophthalmol, 2020, 30(4): 805-816. DOI: 10.1177/1120672120911334.
8. Okuda T, Higashide T, Sugiyama K. Metamorphopsia and outer retinal morphologic changes after successful vitrectomy surgery for macula-off rhegmatogenous retinal detachment[J]. Retina, 2018, 38(1): 148-154. DOI: 10.1097/IAE.0000000000001510.
9. Poulsen CD, Petersen MP, Green A, et al. Fundus autofluorescence and spectral domain optical coherence tomography as predictors for long-term functional outcome in rhegmatogenous retinal detachment[J]. Graefe's Arch Clin Exp Ophthalmol, 2019, 257(4): 715-723. DOI: 10.1007/s00417-018-04222-w.
10. Hirata N, Iwase T, Kobayashi M, et al. Correlation between preoperative factors and final visual acuity after successful rhegmatogenous retinal reattachment [J/OL]. Sci Rep, 2019, 9(1): 3217 [2019-03-01]. https://doi.org/10.1038/s41598-019-39839-2. DOI: 10.1038/s41598-019-39839-2.
11. Murakami T, Okamoto F, Sugiura Y, et al. Changes in metamorphopsia and optical coherence tomography findings after successful retinal detachment surgery[J]. Retina, 2018, 38(4): 684-691. DOI: 10.1097/IAE.0000000000001588.
12. Rossetti A, Doro D, Manfre A, et al. Long-term follow-up with optical coherence tomography and microperimetry in eyes with metamorphopsia after macula-off retinal detachment repair[J]. Eye (Lond), 2010, 24(12): 1808-1813. DOI: 10.1038/eye.2010.138.
13. Zhou C, Lin Q, Chen F. Prevalence and predictors of metamorphopsia after successful rhegmatogenous retinal detachment surgery: a cross-sectional, comparative study[J]. Br J Ophthalmol, 2017, 101(6): 725-729. DOI: 10.1136/bjophthalmol-2016-309097.
14. Lee E, Williamson TH, Hysi P, et al. Macular displacement following rhegmatogenous retinal detachment repair[J]. Br J Ophthalmol, 2013, 97(10): 1297-1302. DOI: 10.1136/bjophthalmol-2013-303637.
15. Bae SH, Kim D, Park TK, et al. Preferential hyperacuity perimeter and prognostic factors for metamorphopsia after idiopathic epiretinal membrane surgery[J]. Am J Ophthalmol, 2013, 155(1): 109-117. DOI: 10.1016/j.ajo.2012.07.007.

Chinese Journal of Ocular Fundus Diseases

Correlation between metamorphopsia and foveal microstructure changes in patients with rhegmatogenous retinal detachment after vitrectomy

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