Postoperative metamorphopsia in macula-off rhegmatogenous retinal detachment: associations with visual function, vision related quality of life, and optical coherence tomography findings

Abstract

Purpose: To evaluate postoperative metamorphopsia in macula-off rhegmatogenous retinal detachment (RRD) and its association with visual function, vision related quality of life, and optical coherence tomography (OCT) findings.

Methods: 45 patients with primary macula-off RRD were included. At 12 months postoperatively, data on metamorphopsia using sine amsler charts (SAC), best corrected visual acuity (BCVA), letter contrast sensitivity, color vision (saturated and desaturated color confusion indexes), critical print size, reading acuity, the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), and OCT, were obtained.

Results: Metamorphopsia was present in 39 patients (88.6%), with most of them (n = 35, 77.8%) showing only mild metamorphopsia (SAC score = 1). Patients with metamorphopsia had significantly worse postoperative BCVA (p = 0.02), critical print size (p<0.0005), and reading acuity (p = 0.001) compared to patients without metamorphopsia. Other visual function outcomes and NEI-VFQ-25 overall composite score were all also somewhat lower in patients with metamorphopsia, but this did not reach statistical significance. No association with OCT findings was present.

Conclusion: The prevalence of postoperative metamorphopsia in macula-off RRD patients is high, however, the degree of metamorphopsia is relatively low. When metamorphopsia is present, visual functions seem to be compromised, while vision related quality of life is only mildly affected.

Fig 1. Mean values (± 2 standard errors) of patients with and those without metamorphopsia of a.

best corrected visual acuity (logMAR), b. letter contrast sensitivity (Log), c. saturated color confusion index (CCI), d. desaturated color confusion index (CCI), e. critical print size, f. reading acuity, and g. overall composite score National Eye Institute Visual Functioning Questionnaire-25. Differences between groups were tested using an independent t-test (desaturated CCI and critical print size) or using a Mann-Whitney U-test (best corrected visual acuity (logMAR), letter contrast sensitivity (Log), saturated CCI, reading acuity, and overall composite score National Eye Institute Visual Functioning Questionnaire-25) and corresponding p-values are given below the figure.