Objective To evaluate quantification of metamorphopsia in eyes with idiopathic macular hole (IMH) before and after surgical treatment, and investigate its relationship between postoperative visual acuity, the macular hole index (MHI), and the macular hole prognostic factor (HPF). Methods Thirty eyes of 30 patients, who underwent successful vitrectomy and internal limiting membrane (ILM) peeling for IMH and were followed up more than 6 months, were included in the study. The uncorrected visual acuity of the fellow eyes was better than 20/25 and there was no metamorphopsia in that eye. The macular hole closure was confirmed by optical coherence tomography (OCT) scans. Metamorphopsia was evaluated by metamorphopsiacharts (M-chart). OCT, best corrected visual acuity (BCVA) and metamorphopsia were obtained before and after surgery. Vertical (MV) and horizontal (MH) metamorphopsia, macular hole index (MHI, the ratio of the height to the diameter of the base), and macular hole prognostic factor (HPF, the ratio of the height to the minimum diameter) were measured. The metamorphopsia score was the average value of MV and MH. SPSS 16.0 statistical analysis software was used for data analysis. Results Preoperative MV and MH were (1.82plusmn;0.04)deg;and (1.81plusmn;0.04)deg;, respectively. Six months after surgery, the MV and MH were (0.17plusmn;0.03)deg;and (0.11plusmn;0.03)deg;respectively. There was significant difference between pre- and post-operative metamorphopsia results (Z=-0.788，P＜0.05). The metamorphopsia score at 6 months after surgery were positively correlated with the value of the postoperative BCVA (LogMAR) (r=0.540,P=0.004) and negatively correlated with the values of preoperative MHI and HPF (r=-0.676, -0.518;P＜0.05). Conclusions Successful vitrectomy and ILM peeling can improve metamorphopsia of IMH. Postoperative metamorphopsia was correlated with the postoperative BCVA and the preoperative macular hole contour.
Objective To evaluate metamorphopsia and vision-related quality of life (VRQoL) and its influencing factor after vitrectomy for idiopathic macular hole (IMH). Methods This is a prospective and non-randomized clinical cohort study. Thirty eyes of 30 IMH patients who received vitrectomy and inner limited membrane (ILM) peeling were included. The best-corrected visual acuity (BCVA), medical refraction test and optical coherence tomography (OCT) were performed. BCVA was recorded as logarithm of the minimum angle of resolution (logMAR). The macular hole index (MHI) was measured using OCT. The average logMAR BCVA and MHI in suffering eyes at baseline were 1.02±0.07 and 0.47±0.02, respectively. The uncorrected visual acuity of the fellow eyes was less than 0.1. Follow-up period was longer than 6 months. At 6 months after surgery, the central retinal thickness (CRT) was measured by OCT; vertical and horizontal metamorphopsia were measured by metamorphopsia charts; VRQoL was evaluated by Chinese VRQoL-25. Spearman correlation analysis was performed to analyze the relationship of VRQoL and postoperative BCVA, metamorphopsia and preoperative MHI. Results At 6 months after surgery, macular hole closure was confirmed by OCT in all patients. The vertical and horizontal metamorphopsia were (0.17±0.03)° and (0.11±0.03)°, respectively. The VRQoL-25 composite score was 79.81±1.29. The average BCVA was 0.59±0.05. The average CRT was (155.10±6.27) μm. The postoperative VRQoL was positive correlated with preoperative MHI (r=0.491,P=0.002), and negative correlated with preoperative BCVA (r=−0.445,P=0.014), postoperative BCVA (r=−0.530,P=0.003) and postoperative metamorphopsia (r=−0.532,P=0.006), but not correlated with the postoperative CRT (r=0.231,P>0.05). Conclusions IMH patients improved their visual acuity after surgery, but still have metamorphopsia. VRQoL was negative correlated with metamorphopsia, positive correlated with preoperative MHI.