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Prevalence and predictors of metamorphopsia after successful rhegmatogenous retinal detachment surgery: a cross-sectional, comparative study
  1. Chuandi Zhou1,
  2. Qiurong Lin2,
  3. Fenge Chen2
  1. 1Department of Ophthalmology, Ninth People's Hospital of Shanghai, Shanghai Jiaotong University, Shanghai, China
  2. 2Department of Ophthalmology, First People's Hospital of Shanghai, Shanghai Jiaotong University, Shanghai, China
  1. Correspondence to Dr Fenge Chen, Department of Ophthalmology, First People's Hospital of Shanghai, Shanghai Jiaotong University, 100 Haining Road, Hongkou District, Shanghai 200080, China; fenge_chen{at}163.com

Abstract

Aims To evaluate the prevalence of metamorphopsia after successful rhegmatogenous retinal detachment (RRD) surgery and determine the independent predictors of metamorphopsia.

Methods A cross-sectional, comparative study. The study included 380 eyes of 357 patients who underwent a successful RRD surgery between 2009 and 2015. The presence of metamorphopsia was tested with an Amsler grid and the foveal microstructure was scanned with high-resolution spectral-domain optical coherence tomography (OCT) at a follow-up visit. Medical records were reviewed for preoperative and intraoperative factors associated with postoperative visual recovery.

Results The mean follow-up period was 35.1±19.6 months. The prevalence of metamorphopsia in our study was 46.58% (177/380), whereas in macula-off cases this number increased to 56.69% (144/254). Stepwise logistic regression analysis indicated that younger age at the diagnosis (OR=0.97, p<0.01), preoperative macula-off status (OR=3.34, p<0.01), postoperative presence of subretinal fluid (SRF) (OR=3.58, p=0.01) and disrupted external limiting membrane (ELM) junction (OR=1.79, p=0.02) were the independent predictors for metamorphopsia after surgery. The abnormal foveal microstructures after successful surgeries mainly included six types: disrupted inner segment/outer segment (133 eyes, 35.00%), disrupted ELM (131 eyes, 34.47%), epiretinal membrane (44 eyes, 11.58%), SRF (26 eyes, 6.84%), macular hole (9 eyes, 2.37%) and cystoid macular oedema (6 eyes, 1.58%).

Conclusions Considering metamorphopsia, special attention should be paid to young patients and/or the cases with involvement of macula. High-resolution OCT is informative in detecting anatomic abnormalities after RRD surgery. The postoperative presence of SRF and disrupted ELM line are independent predictors of metamorphopsia.

  • Retina
  • Treatment Surgery
  • Visual perception

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