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.
Objective To analyze the correlation of foveal avascular zone (FAZ) size with visual acuity and metamorphopsia in idiopathic macular epiretinal membrane (IMEM) eyes. Methods This is a cross-sectional study, including 43 patients (43 eyes) with IMEM (IMEM group) and 35 health subjects (35 eyes) as control group. The best corrected visual acuity (BCVA) was measured using the international standard visual acuity chart, and the results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity. The severity of metamorphopsia was measured using M-charts. The FAZ areas were estimated with optical coherence tomography angiography (OCTA) in both the superficial and deep capillary plexus layers. The central macular thickness (CMT) was assessed with spectral-domain optical coherence tomography. There was no difference of logMAR BCVA and CMT between two groups (Z=−7.379, −7.560; P＜0.001). The differences of FAZ areas between the two groups were analyzed. The correlative analysis was performed to investigate the relationship between FAZ areas and visual acuity as well as metamorphopsia. Results The FAZ area in superficial and deep capillary plexus in IMEM group were smaller than those in control group (t=−30.316, −27.606; P＜0.001). In IMEM group, the mean M-score was 0.41±0.32; the horizontal and vertical M-score were 0.49±0.40 and 0.32±0.29, respectively. The horizontal M-score was higher than vertical M-score with the significant difference (Z=−2.000, P=0.046). In IMEM group, the FAZ area in superficial capillary plexus correlated inversely with metamorphopsia (r=−0.709, P＜0.001); the FAZ area in deep capillary plexus correlated inversely with metamorphopsia and BCVA (r=−0.533, −0.838; P＜0.001). Conclusions The FAZ areas are significantly decreased in IMEM eyes compared with normal eyes. Both superficial and deep FAZ areas are correlated with metamorphopsia, and deep FAZ area is also correlated with BCVA.