Comparative analysis of metamorphopsia and aniseikonia after vitrectomy for epiretinal membrane, macular hole, or rhegmatogenous retinal detachment

Hisashi Fukuyama, Hiroto Ishikawa, Yuki Komuku, Takashi Araki, Naoki Kimura, Fumi Gomi, Hisashi Fukuyama, Hiroto Ishikawa, Yuki Komuku, Takashi Araki, Naoki Kimura, Fumi Gomi

Abstract

This study investigated postoperative changes in metamorphopsia and aniseikonia in eyes that underwent vitrectomy for epiretinal membrane (ERM), macular hole (MH), or rhegmatogenous retinal detachment (RRD). In total, 166 eyes were included from 166 patients with ERM, MH, or RRD who underwent primary vitrectomy. Metamorphopsia and aniseikonia were quantified by M-CHARTS and the New Aniseikonia Test (NAT). Best-corrected visual acuity (BCVA), M-CHARTS, NAT assessments, and OCT examination were performed at 1, 3, and 6 months postoperatively. Of the 166 eyes, 65 had ERM, 21 had MH, 42 had macula-off RRD, and 38 had macula-on RRD. BCVA improved significantly between 1 and 6 months postoperatively in eyes with ERM, MH, and macula-off RRD (P = 0.0057, P = 0.0065, and P = 0.0021, respectively). M-CHARTS scores at 1 month postoperatively significantly decreased in eyes with ERM (P = 0.0034) and tended to decrease in eyes with MH (P = 0.068). NAT scores did not change between baseline and 1 month postoperatively in eyes with ERM or MH. Between 1 and 6 months postoperatively, M-CHARTS and NAT scores significantly decreased in eyes with macula-off RRD (P = 0.0064 and P = 0.0009, respectively), but not in eyes with ERM, MH, or macula-on RRD. At 6 months postoperatively, significant metamorphopsia was evident in 33.3% of eyes with ERM, 29.2% of eyes with MH, and 35.7% of eyes with macula-off RRD; 61.5% of eyes with ERM showed macropsia and 52.3% of eyes with macula-off RRD showed micropsia. In eyes with ERM, more central retinal thickness (CRT) correlated with postoperative BCVA, and deep retinal folds on enface OCT image correlated with postoperative metamorphopsia. In eyes with macula-off RRD, less CRT correlated with postoperative BCVA, and tended to correlate with postoperative micropsia. Macular morphologies could contribute to differences in postoperative visual acuity, metamorphopsia, and aniseikonia.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Time Course of Best-Corrected Visual…
Fig 1. Time Course of Best-Corrected Visual Acuity (BCVA), M-score, and absolute NAT score.
Abbreviations: ERM = epiretinal membrane, MH = macular hole, RRD = rhegmatogenous retinal detachment, M-off = macula off, M-on = macula on.
Fig 2. Distributions of metamorphopsia and aniseikonia…
Fig 2. Distributions of metamorphopsia and aniseikonia at 6 months postoperatively.
Abbreviations: ERM = epiretinal membrane, MH = macular hole, RRD = rhegmatogenous retinal detachment, M-off = macula off, M-on = macula on.
Fig 3. Macular morphological changes on enface…
Fig 3. Macular morphological changes on enface OCT findings.
Enface OCT in the middle retina (A, D, G) and outer retina (B, E, H), as well as cross-sectional OCT images (C, F, I) for eyes with ERM (A–C), eyes with MH (D–F), and eyes with macula-off RRD (G–I). Middle retina comprises the area between the border of the inner plexiform layer and inner nuclear layer, extending to 91.0 μm from the RPE (highlighted in purple on cross-sectional OCT); outer retina comprises the area between 91.0 μm from the RPE to the RPE (highlighted in green) (C, F, I). In eyes with ERM, undulation of the outer nuclear layer appeared as concentric folds on en face OCT images of middle retina (A); in eyes with MH, retinal cysts (D) were observed in middle retina, while foveal detachment was observed in outer retina (E). In eyes with macula-off RRD, en face OCT images of outer retina showed several sharp and dull folds (H). Abbreviations: ERM = epiretinal membrane, MH = macular hole, RRD = rhegmatogenous retinal detachment, RPE = retinal pigment membrane, OCT = optical coherence tomography.

References

    1. Of ES, The OF.) Earliest Symptoms of Diseases. 1953; 521–537.
    1. Midena E, Vujosevic S. Metamorphopsia: An Overlooked Visual Symptom. Ophthalmic Res. 2015;55: 26–36. 10.1159/000441033
    1. BERENS C, RE B. Aniseikonia: A present appraisal and some practical considerations. Arch Ophthalmol. 1963;70: 181–188. Available: 10.1001/archopht.1963.00960050183009
    1. de Wit GC. Retinally-induced aniseikonia. Binocul Vis Strabismus Q. 2007;22: 96–101.
    1. Benegas NM, Egbert J, Engel WK, Kushner BJ. Diplopia secondary to aniseikonia associated with macular disease. Arch Ophthalmol. 1999;117: 896–899. 10.1001/archopht.117.7.896
    1. Wang Y, Li SY, Zhu M, Chen SJ, Liu Y, Men XH, et al. Metamorphopsia after successful retinal detachment surgery: An optical coherence tomography study. Acta Ophthalmol Scand. 2005;83: 168–171. 10.1111/j.1600-0420.2005.00413.x
    1. Chung H, Son G, Hwang DJ, Lee K, Park Y, Sohn J. Relationship between vertical and horizontal aniseikonia scores and vertical and horizontal OCT images in idiopathic epiretinal membrane. Investig Ophthalmol Vis Sci. 2015;56: 6542–6548. 10.1167/iovs.15-16874
    1. Van De Put MAJ, Vehof J, Hooymans JMM, Los LI. Postoperative metamorphopsia in macula-off rhegmatogenous retinal detachment: Associations with visual function, vision related quality of life, and optical coherence tomography findings. PLoS One. 2015;10 10.1371/journal.pone.0120543
    1. Kinoshita T, Imaizumi H, Miyamoto H, Okushiba U, Hayashi Y, Katome T, et al. Changes in metamorphopsia in daily life after successful epiretinal membrane surgery and correlation with M-CHARTS score. Clin Ophthalmol. 2015;9: 225–233. 10.2147/OPTH.S76847
    1. Arimura E, Matsumoto C, Okuyama S, Takada S, Hashimoto S, Shimomura Y. Quantification of metamorphopsia in a macular hole patient using M-CHARTS™. Acta Ophthalmol Scand. 2007;85: 55–59. 10.1111/j.1600-0420.2006.00729.x
    1. Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T. Aniseikonia and foveal microstructure after retinal detachment surgery. Investig Ophthalmol Vis Sci. 2014;55: 4880–4885. 10.1167/iovs.14-14618
    1. Okamoto F, Sugiura Y, Moriya Y, Murakami T, Okamoto Y, Hiraoka T, et al. Aniseikonia and Foveal Microstructure in Patients with Idiopathic Macular Hole. Ophthalmology. American Academy of Ophthalmology; 2016;123: 1926–1932. 10.1016/j.ophtha.2016.05.051
    1. Kinoshita T, Imaizumi H, Okushiba U, Miyamoto H, Ogino T, Mitamura Y. Time course of changes in metamorphopsia, visual acuity, and OCT parameters after successful epiretinal membrane surgery. Investig Ophthalmol Vis Sci. 2012;53: 3592–3597. 10.1167/iovs.12-9493
    1. Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T. Time course of changes in aniseikonia and foveal microstructure after vitrectomy for epiretinal membrane. Ophthalmology. Elsevier Inc; 2014;121: 2255–2260. 10.1016/j.ophtha.2014.05.016
    1. Chua SYL, Dhillon B, Aslam T, Balaskas K, Yang Q, Keane PA, et al. Associations with photoreceptor thickness measures in the UK Biobank. Sci Rep. 2019;9: 19440 10.1038/s41598-019-55484-1
    1. Lange C, Feltgen N, Junker B, Schulze-Bonsel K, Bach M. Resolving the clinical acuity categories “hand motion” and “counting fingers” using the Freiburg Visual Acuity Test (FrACT). Graefes Arch Clin Exp Ophthalmol. 2009;247: 137–142. 10.1007/s00417-008-0926-0
    1. Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant. 2013;48: 452–458. 10.1038/bmt.2012.244
    1. Wong JG, Sachdev N, Beaumont PE, Chang AA. Visual outcomes following vitrectomy and peeling of epiretinal membrane. Clin Experiment Ophthalmol. 2005;33: 373–378. 10.1111/j.1442-9071.2005.01025.x
    1. Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T. Metamorphopsia and optical coherence tomography findings after rhegmatogenous retinal detachment surgery. Am J Ophthalmol. 2014;157: 214–220.e1. 10.1016/j.ajo.2013.08.007
    1. Sugiura Y, Okamoto F, Okamoto Y, Hiraoka T, Oshika T. RELATIONSHIP BETWEEN METAMORPHOPSIA AND INTRARETINAL CYSTS WITHIN THE FLUID CUFF AFTER SURGERY FOR IDIOPATHIC MACULAR HOLE. Retina. 2017;37: 70–75. 10.1097/IAE.0000000000001136
    1. Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T. Aniseikonia in various retinal disorders. Graefe’s Arch Clin Exp Ophthalmol. Graefe’s Archive for Clinical and Experimental Ophthalmology; 2017;255: 1063–1071. 10.1007/s00417-017-3597-x
    1. Kitao M, Wakabayashi T, Nishida K, Sakaguchi H, Nishida K. Long-term reconstruction of foveal microstructure and visual acuity after idiopathic macular hole repair: Three-year follow-up study. Br J Ophthalmol. 2019;103: 238–244. 10.1136/bjophthalmol-2017-311689
    1. Sheales MP, Kingston ZS, Essex RW. Associations between preoperative OCT parameters and visual outcome 3 months postoperatively in patients undergoing vitrectomy for idiopathic epiretinal membrane. Graefe’s Arch Clin Exp Ophthalmol. 2016;254: 1909–1917. 10.1007/s00417-016-3326-x
    1. Itoh Y, Inoue M, Rii T, Hirota K, Hirakata A. Correlation between foveal cone outer segment tips line and visual recovery after epiretinal membrane surgery. Investig Ophthalmol Vis Sci. 2013;54: 7302–7308. 10.1167/iovs.13-12702
    1. Wakabayashi T, Oshima Y, Fujimoto H, Murakami Y, Sakaguchi H, Kusaka S, et al. Foveal Microstructure and Visual Acuity after Retinal Detachment Repair. Imaging Analysis by Fourier-Domain Optical Coherence Tomography. Ophthalmology. 2009;116: 519–528. 10.1016/j.ophtha.2008.10.001
    1. Fukuyama H, Yagiri H, Araki T, Iwami H, Yoshida Y, Ishikawa H, et al. Quantitative assessment of outer retinal folds on enface optical coherence tomography after vitrectomy for rhegmatogenous retinal detachment. Sci Rep. 2019;9: 2327 10.1038/s41598-019-38751-z
    1. dell’Omo R, Tan HS, Schlingemann RO, Bijl HM, Lesnik Oberstein SY, Barca F, et al. Evolution of outer retinal folds occurring after vitrectomy for retinal detachment repair. Invest Ophthalmol Vis Sci. 2012;53: 7928–7935. 10.1167/iovs.12-10322
    1. Bae SH, Kim D, Park TK, Han JR, Kim H, Nam W. Preferential hyperacuity perimeter and prognostic factors for metamorphopsia after idiopathic epiretinal membrane surgery. Am J Ophthalmol. Elsevier Inc.; 2013;155: 109–117. 10.1016/j.ajo.2012.07.007
    1. Kobayashi M, Iwase T, Yamamoto K, Ra E, Murotani K, Matsui S, et al. Association between photoreceptor regeneration and visual acuity following surgery for rhegmatogenous retinal detachment. Investig Ophthalmol Vis Sci. 2016;57: 889–898. 10.1167/iovs.15-18403
    1. Ichikawa Y, Imamura Y, Ishida M. Associations of aniseikonia with metamorphopsia and retinal displacements after epiretinal membrane surgery. Eye (Lond). 2018;32: 400–405. 10.1038/eye.2017.201
    1. Jensen OM, Larsen M. Objective assessment of photoreceptor displacement and metamorphopsia: A study of macular holes. Arch Ophthalmol. 1998;116: 1303–1306. 10.1001/archopht.116.10.1303
    1. Franze K, Grosche J, Skatchkov SN, Schinkinger S, Foja C, Schild D, et al. Müller cells are living optical fibers in the vertebrate retina. Proc Natl Acad Sci U S A. 2007;104: 8287–8292. 10.1073/pnas.0611180104
    1. Ugarte M, Williamson TH. Horizontal and vertical micropsia following macula-off rhegmatogenous retinal-detachment surgical repair. Graefes Arch Clin Exp Ophthalmol. 2006;244: 1545–1548. 10.1007/s00417-006-0290-x
    1. Pesin SR, Olk RJ, Grand MG, Boniuk I, Arribas NP, Thomas MA, et al. Vitrectomy for premacular fibroplasia. Prognostic factors, long-term follow-up, and time course of visual improvement. Ophthalmology. 1991;98: 1109–1114. 10.1016/s0161-6420(91)32169-9
    1. Oshima Y, Yamanishi S, Sawa M, Motokura M, Harino S, Emi K. Two-year follow-up study comparing primary vitrectomy with scleral buckling for macula-off rhegmatogenous retinal detachment. Jpn J Ophthalmol. 2000;44: 538–549. 10.1016/s0021-5155(00)00205-7
    1. Sjostrand J, Anderson C. Micropsia and metamorphopsia in the re-attached macula following retinal detachment. Acta Ophthalmol. 1986;64: 425–432.

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