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Choi J, Lim SG, Kang SW, Kim SJ, Son KY, Hwang S. THE IMPACT OF EARLY SURGICAL INTERVENTION ON ANISEIKONIA IN PATIENTS WITH EPIRETINAL MEMBRANE: A Prospective Cohort Study. Retina 2024; 44:1529-1537. [PMID: 39167574 DOI: 10.1097/iae.0000000000004146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
PURPOSE To investigate the efficacy of early surgical intervention in ameliorating aniseikonia among patients with epiretinal membrane. METHODS This prospective cohort study enrolled patients who underwent surgery for epiretinal membrane. Patients were divided into early (symptom onset within 1 year) and late (symptom onset ≥1 year) treatment groups. Changes in aniseikonia, best-corrected visual acuity, and tangential retinal displacement were assessed and compared at 6 and 12 months postoperatively. RESULTS Of the 56 patients, 30 (53.6%) belonged to the early treatment group and 26 (46.4%) to the late treatment group. The early treatment group demonstrated a significant reduction in aniseikonia score at 6- and 12-month follow-up visits (-1.10 ± 1.50 [P = 0.002] and -1.18 ± 1.79 [P = 0.003], respectively); however, no improvement was observed in the late treatment group (0.98 ± 4.62 [P = 0.310] and 1.52 ± 4.35 [P = 0.124], respectively). The early treatment group showed larger tangential retinal displacement at the 12-month postoperative follow-up visit. In addition, the amount of tangential retinal displacement was associated with postoperative changes in aniseikonia. CONCLUSION Early surgical intervention is helpful in improving aniseikonia in patients with epiretinal membrane. The degree of recovery in inner retinal displacement was associated with the improvement of aniseikonia.
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Affiliation(s)
- Jaehwan Choi
- Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University, Seoul, Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea; and
| | - Seul Gi Lim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Woong Kang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Jin Kim
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Young Son
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sungsoon Hwang
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Ng HJ, Vermeer KA, La Heij EC, Kuip CP, van Meurs JC. Retinal damage extends beyond the border of the detached retina in fovea-on retinal detachment. Acta Ophthalmol 2024; 102:285-295. [PMID: 37221643 DOI: 10.1111/aos.15713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 04/21/2023] [Accepted: 05/05/2023] [Indexed: 05/25/2023]
Abstract
PURPOSE The aim of this study was to investigate the preoperative and postoperative change in retinal sensitivity in relation to the distance to the retinal detachment (RD) in patients with fovea-on RD. METHODS We prospectively evaluated 13 patients with fovea-on RD and a healthy control eye. Preoperatively, OCT scans of the RD border and the macula were obtained. The RD border was highlighted on the SLO image. Microperimetry was used to assess the retinal sensitivity at the macula, the RD border and the retina around the RD border. At 6 weeks, 3 and 6 months postoperatively, follow-up examinations of OCT and microperimetry were performed in the study eye. Microperimetry was performed once in control eyes. Microperimetry data were overlaid on the SLO image. The shortest distance to the RD border was calculated for each sensitivity measurement. The change in retinal sensitivity was calculated as control-study. The relation between the change in retinal sensitivity and the distance to the RD border was assessed using a locally weighted scatterplot smoothing curve. RESULTS Preoperatively, the greatest loss in retinal sensitivity was 21 dB at 3° inside the RD which decreased linearly, through the RD border, and reached a plateau of 2 dB at 4°. For 6 weeks and 3 months postoperatively, the greatest retinal sensitivity loss remained at 3° inside the RD but was 4 dB and sensitivity loss decreased linearly to a plateau of 0 dB at 5° outside the RD. At 6 months postoperatively, the greatest sensitivity loss was 2 dB at 3° inside the RD, and decreased linearly to a plateau of 0 dB at 2° outside the RD. CONCLUSIONS Retinal damage extends beyond the detached retina. Retinal sensitivity loss of the attached retina decreased drastically as the distance to the RD increased. Postoperative recovery occurred for both attached and detached retina.
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Affiliation(s)
- Hei Jan Ng
- The Rotterdam Eye Hospital, Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
| | - Koenraad A Vermeer
- The Rotterdam Eye Hospital, Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
| | - Ellen C La Heij
- The Rotterdam Eye Hospital, Vitreoretinal Surgery, Rotterdam, The Netherlands
| | - Caroline P Kuip
- The Rotterdam Eye Hospital, Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
| | - Jan C van Meurs
- The Rotterdam Eye Hospital, Vitreoretinal Surgery, Rotterdam, The Netherlands
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
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Xu L, Liu L, Yu B, Yang N, Wu H. Quantifying the Relationship Between Unilateral Induced Metamorphopsia and Stereopsis Impairment. Invest Ophthalmol Vis Sci 2024; 65:2. [PMID: 38558094 PMCID: PMC10996984 DOI: 10.1167/iovs.65.4.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose To investigate the relationship between unilateral metamorphopsia, characterized by visual distortions in one eye, and impaired stereopsis. Methods Utilizing both near and distance measurements through advanced testing systems, including 4K smartphones and an active shutter three-dimensional system, we simulated varying degrees of unilateral metamorphopsia in 30 healthy young adults aged between 21 and 29 years. Two types of contour-based stereotest symbols, lines and squares, were developed. Distortions were classified into six distinct patterns, each further divided into eight grades of severity. Participants were tasked with identifying visual targets, and their stereothresholds were determined under different conditions of induced distortion. Stereopsis was measured within a range of 2.9 to 1.0 log arcsec, at 0.2 log arcsec intervals. Stereopsis changes under different distortion scenarios were analyzed using the generalized estimating equations, with a sequential Bonferroni adjustment applied for pairwise comparisons. Results A direct and quantifiable correlation was observed between the severity of metamorphopsia and reductions in stereopsis. As the degree of visual distortion increased, notably in both frequency and amplitude, there was a corresponding decline in stereopsis. This relationship held true in both near and distance measurements of stereopsis. Statistical analyses further reinforced these findings, highlighting a significant detrimental effect of distortion components on stereoacuity. Conclusions The findings highlight the clinical significance of understanding the interplay between unilateral metamorphopsia and stereopsis. Early interventions in conditions leading to metamorphopsia might be critical to maintaining optimal stereopsis.
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Affiliation(s)
- Lingxian Xu
- Department of Optometry, The Second Hospital of Jilin University, Changchun, China
| | - Lu Liu
- Department of Optometry, The Second Hospital of Jilin University, Changchun, China
| | - Bo Yu
- Department of Optometry, The Second Hospital of Jilin University, Changchun, China
| | - Ning Yang
- Department of Optometry, The Second Hospital of Jilin University, Changchun, China
| | - Huang Wu
- Department of Optometry, The Second Hospital of Jilin University, Changchun, China
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Shen S, Jin S, Li F, Zhao J. Optical coherence tomography parameters as prognostic factors for stereopsis after vitrectomy for unilateral epiretinal membrane: a cohort study. Sci Rep 2024; 14:6715. [PMID: 38509172 PMCID: PMC10954640 DOI: 10.1038/s41598-024-57203-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/15/2024] [Indexed: 03/22/2024] Open
Abstract
This retrospective cohort study explored the relationship between monocular and interocular optical coherence tomography (OCT) parameters and stereopsis in 56 patients undergoing pars plana vitrectomy (PPV) for unilateral idiopathic epiretinal membrane (IERM). IERM impairs visual functions, with symptoms ranging from asymptomatic to severe impairment. Despite established surgical interventions, including PPV with membrane peeling, the impact on advanced three-dimensional visual functions such as stereopsis remains inadequately investigated. All subjects were assessed for stereopsis, visual acuity, and metamorphopsia, alongside spectral domain OCT parameters. These visual functions significantly improved 3-month postoperatively. Central retinal thickness at the fovea, parafovea, and perifovea (CFT, CRT-3 mm, and CRT-6 mm), ectopic inner foveal layer thickness, and retinal layer thickness notably decreased 1 week to 3 months after surgery. The interocular difference in OCT parameters between bilateral eyes was included as a parameter. Baseline CRT-3 mm difference and inner nuclear layer (INL) thickness were independently correlated with postoperative stereopsis on the Titmus Stereo Test, while baseline CRT-6 mm difference and INL thickness were independently related to stereopsis on the TNO stereotest. This study highlights the substantial enhancement in stereopsis post-IERM surgery, with both interocular and monocular OCT parameters independently influencing postoperative stereopsis. These findings underscore the importance of retinal microstructures in assessing and predicting stereopsis in IERM patients after vitrectomy.
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Affiliation(s)
- Simei Shen
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, 130041, China
| | - Siyan Jin
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, 130041, China
| | - Fuqiang Li
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, 130041, China
| | - Jinsong Zhao
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, 130041, China.
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Takeyama A, Imamura Y, Fujimoto T, Iida T, Komiya Y, Ishida M. Aniseikonia and retinal morphological changes in eyes undergoing macular hole surgery. Sci Rep 2024; 14:59. [PMID: 38168792 PMCID: PMC10762157 DOI: 10.1038/s41598-023-51032-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024] Open
Abstract
Even after idiopathic macular hole (MH) surgery and with successful closure of MH, aniseikonia is a common postoperative symptom. We investigated the correlation of MH diameter, retinal displacement and retinal layer thicknesses with aniseikonia in 41 eyes of 41 patients undergoing MH surgery with internal limiting membrane peeling. Aniseikonia was measured with the New Aniseikonia Test. Retinal displacement (RD%) was defined as change of retinal distance between the temporal margin of the optic papilla and the intersection of the retinal vessels. Changes of thicknesses of the inner nuclear layer (INL%) and the outer retinal layer (OR%) were calculated. Aniseikonia improved postoperatively. Preoperative aniseikonia and their improvement at 6 months correlated with MH diameters (P = 0.004-0.046). Improvement of aniseikonia correlated with temporal RD% (P = 0.002-0.012). Improvement of vertical aniseikonia correlated with INL% at 2 weeks and with the nasal OR% at 1, 3, and 6 months (P = < 0.001-0.028). MH diameter and age were significant predictors for improvement of aniseikonia. The greater the temporal retina displacement, and the thinner the postoperative INL and OR, the greater the improvement of aniseikonia. MH diameter and age are strong predictors for improvement of aniseikonia after MH surgery.
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Affiliation(s)
- Asuka Takeyama
- Department of Ophthalmology, Toho University Ohashi Medical Center, 2-22-36, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan.
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan.
| | - Yutaka Imamura
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan
| | - Taichi Fujimoto
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan
| | - Toshiya Iida
- Department of Ophthalmology, Toho University Ohashi Medical Center, 2-22-36, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan
| | - Yuko Komiya
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan
| | - Masahiro Ishida
- Department of Ophthalmology, Toho University Ohashi Medical Center, 2-22-36, Ohashi, Meguro-ku, Tokyo, 153-8515, Japan
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan
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Liu L, Xu L, Guo J, Zhao L, Wu H. Evaluating the relationship between induced aniseikonia and distance stereopsis. ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:37. [PMID: 36819555 PMCID: PMC9929788 DOI: 10.21037/atm-22-5575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/25/2022] [Indexed: 01/12/2023]
Abstract
Background The impact of aniseikonia on stereopsis has been studied for decades, however, inconsistency which may be partly attributed to the method of inducing aniseikonia exists among these findings. This study aimed to induce overall and meridional aniseikonia using a three-dimensional (3D) computer and then evaluate the effect of induced aniseikonia on distance stereopsis using contour-based and random-dot-based patterns. Methods A 3D laptop was used to produce all of the test symbols. Unlike the usual method of creating aniseikonia with size lenses, which would change not only the size but also the relative position of the test symbols in the two images as seen by the two eyes, a new test system was designed to evaluate the aniseikonia, which only modified the size while maintaining the relative position of the test symbols. This new method reduced the disparities induced by location changing of the paired test targets when inducing aniseikonia. Aniseikonia was induced overall or in one of the meridians. The induced meridional aniseikonia included 180°, 30°, 45°, 60°, and 90°, respectively. The range of induced aniseikonia was 0-30% with an increment of 5%. Results Overall magnification affected stereopsis more than magnification in any one of the meridians. The stereoacuity differences between oblique meridians (30°, 45°, and 60°) were not significant until the aniseikonia increased up to 20%. The difference between 180°, 45°, and 90° was significant when the aniseikonia increased up to 10% in the contour-based test and over 20% in the random-dot-based test. The stereoacuity trend was improved gradually, coupled with the angle changing from 180º to 90º in the contour-based pattern, and deteriorated gradually in the random-dot-based pattern. Conclusions Overall aniseikonia affected stereopsis more than meridional aniseikonia. The stereoacuity of the contour-based pattern was superior to that of the random-dot-based pattern in the 90° meridian, while the opposite result was obtained in the 180° meridian.
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One-year outcomes of metamorphopsia and retinal displacement after epiretinal membrane surgery. Retina 2022; 42:1756-1761. [PMID: 35512112 DOI: 10.1097/iae.0000000000003522] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine 1-year outcomes of metamorphopsia and tangential retinal displacement after epiretinal membrane (ERM) surgery and identify predictors for metamorphopsia score at 1 year and its improvement from baseline. METHODS M-CHARTS were used to measure metamorphopsia. Distances between the intersections of 2 sets of retinal vessels were measured with infrared or autofluorescence images. Predictors for metamorphopsia scores at 1 year after surgery and their differences from baseline were identified with multivariate regression analysis. RESULTS Ninety-two eyes of 90 consecutive patients were included. The vertical and horizontal distances continued expanding for 1 year (P< 0.001). Both vertical and horizontal metamorphopsia scores improved 3 months after surgery (P= 0.025 and P< 0.001, respectively), and horizontal scores continued improving for a year. Horizontal metamorphopsia scores correlated with retinal displacement more strongly than vertical scores. Higher metamorphopsia score at baseline is predictive for that at 1 year. Older age and male are predictive for less improvement of the score at 1 year from baseline. CONCLUSIONS Metamorphopsia correlates with tangential retinal displacement at 1 year after ERM surgery. Horizontal metamorphopsia scores keep improving until 1 year postoperatively. Male and older age are both independent predictors for poor improvement of metamorphopsia after ERM surgery.
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Kanzaki Y, Doi S, Matoba R, Kanzaki S, Kimura S, Hosokawa MM, Shiode Y, Takasu I, Morizane Y. OBJECTIVE AND QUANTITATIVE ESTIMATION OF THE OPTIMAL TIMING FOR EPIRETINAL MEMBRANE SURGERY ON THE BASIS OF METAMORPHOPSIA. Retina 2022; 42:704-711. [PMID: 34983900 DOI: 10.1097/iae.0000000000003401] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To establish an objective and quantitative biomarker of metamorphopsia in epiretinal membranes (ERMs) and determine the optimal timing for ERM surgery. METHODS Retrospectively, 172 eyes with ERM were reviewed. Retinal folds because of tangential traction by ERM were visualized by en-face optical coherence tomography. The maximum depth of retinal folds (MDRF) within the parafovea was quantified. Metamorphopsia was quantified by M-CHARTS. The change in the distance between the retinal vessels after ERM surgery and the preoperative total depth of retinal folds between the vessels were quantified using en-face optical coherence tomography and optical coherence tomography angiography. RESULTS Significant correlations were observed between preoperative MDRF and M-CHARTS scores before and at 6 months after surgery (r = 0.617 and 0.460, respectively; P < 0.001) and change in the distance between the retinal vessels after ERM surgery and preoperative total depth of retinal folds between the vessels (r = 0.471; P = 0.013). The preoperative MDRF values at which M-CHARTS scores were 0.5 before and 6 months after the surgery were 69 µm and 118 µm, respectively. CONCLUSION The MDRF is an objective and quantitative biomarker of metamorphopsia in ERM. To maintain patients' quality of vision, ERM surgery may be performed when the preoperative MDRF ranges between 69 µm and 118 µm.
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Affiliation(s)
- Yuki Kanzaki
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama City, Okayama, Japan; and
| | - Shinichiro Doi
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama City, Okayama, Japan; and
| | - Ryo Matoba
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama City, Okayama, Japan; and
| | - Sayumi Kanzaki
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama City, Okayama, Japan; and
| | - Shuhei Kimura
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama City, Okayama, Japan; and
| | - Mio M Hosokawa
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama City, Okayama, Japan; and
| | - Yusuke Shiode
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama City, Okayama, Japan; and
| | - Ippei Takasu
- Department of Ophthalmology, Takasu Eye Clinic, Okayama City, Okayama, Japan
| | - Yuki Morizane
- Department of Ophthalmology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama City, Okayama, Japan; and
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Long-term functional outcomes and vision-related quality of life after vitrectomy for epiretinal membrane: a prospective cohort study. Sci Rep 2022; 12:2470. [PMID: 35169203 PMCID: PMC8847664 DOI: 10.1038/s41598-022-06482-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/31/2022] [Indexed: 11/09/2022] Open
Abstract
To investigate the long-term effect of unilateral idiopathic epiretinal membrane (uiERM) removal on monocular and binocular visual function, and on vision-related quality of life (VR-QoL). Prospective, single-center study. The following data were collected before and after surgery: distance monocular and binocular best-corrected visual acuity (BCVA), horizontal and vertical metamorphopsia, horizontal and vertical aniseikonia, stereoacuity and National Eye Institute Visual Function Questionnaire-25 item (NEI VFQ-25). Forty-two patients (mean age: 72.7 ± 7.4 years; 24 men) were included. At 6 months postoperatively, distance monocular BCVA (p < 0.001), horizontal metamorphopsia (p = 0.001) and the composite score of NEI VFQ-25 (p < 0.001) significantly improved, in comparison to baseline. At 2 years postoperatively, distance monocular (p < 0.001) and binocular (p = 0.01) BCVA, horizontal (p < 0.001) and vertical (p = 0.02) metamorphopsia, vertical aniseikonia (p = 0.01), stereoacuity (p < 0.001) and 3 subscales scores of the NEI VFQ-25 (p < 0.05) (“general vision”, “mental health”, “driving”) significantly improved in comparison to baseline.
Removal of uiERM improves VR-QoL and achieves good visual outcomes on both monocular and binocular visual parameters over long-term. Visual symptoms induced by macular contraction have different improvement kinetics after surgery. Stereopsis, the highest level of binocular vision, can be improved in some cases.
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Kim BH, Kim DI, Bae KW, Park UC. Influence of postoperative ectopic inner foveal layer on visual function after removal of idiopathic epiretinal membrane. PLoS One 2021; 16:e0259388. [PMID: 34735519 PMCID: PMC8568108 DOI: 10.1371/journal.pone.0259388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/18/2021] [Indexed: 11/22/2022] Open
Abstract
Purpose To investigate the functional and anatomical parameters and their postoperative changes according to the ectopic inner foveal layer (EIFL) staging scheme for idiopathic epiretinal membrane (ERM). Methods In this prospective study, patients with idiopathic ERM underwent pars plana vitrectomy and ERM removal, and were followed-up for 6 months. The associations of EIFL with pre- and postoperative functional and anatomical parameters were analyzed. Results A total of 84 eyes (84 patients) were included: 39 (46.4%), 33 (39.3%), and 12 (14.3%) as EIFL stages 2, 3, and 4, respectively. At 6 months after surgery, the mean best-corrected visual acuity (BCVA) significantly improved in all EIFL stages (P ≤ 0.003); however, metamorphopsia improved only in eyes with EIFL stage 2 (P = 0.039) and 3 (P = 0.011). The aniseikonia and foveal avascular zone (FAZ) area showed no significant postoperative changes in any of the EIFL stages. Both preoperatively and during 6 months after surgery, the EIFL stage showed a significant correlation with BCVA (P ≤ 0.033), metamorphopsia (P ≤ 0.008), central macular thickness (P < 0.001), and FAZ parameters (P ≤ 0.016) at each time point, but not with aniseikonia. Significant correlations of EIFL thickness with BCVA (P = 0.028) and metamorphopsia (P = 0.006) before surgery were not persistent after surgery. Conclusion Both pre- and postoperatively, the staging of EIFL, rather than its thickness, is a simple and adequate surrogate marker for visual acuity and metamorphopsia in eyes with idiopathic ERM.
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Affiliation(s)
- Bo Hee Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Ik Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Woong Bae
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Un Chul Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
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Aniseikonia following intravitreal ranibizumab treatment for branch retinal vein occlusion. Jpn J Ophthalmol 2021; 65:672-679. [PMID: 34250549 DOI: 10.1007/s10384-021-00852-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/14/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To quantify aniseikonia following intravitreal ranibizumab (IVR) in patients with branch retinal vein occlusion (BRVO) and assess the relationship between aniseikonia and retinal microstructure. STUDY DESIGN Prospective observational study. METHODS This study included 50 patients undergoing IVR treatment for unilateral BRVO. The degree of aniseikonia and best-corrected visual acuity (BCVA) was examined, and retinal microstructure was assessed with optical coherence tomography (OCT) before and 1, 2, 3, 4, 5, and 6 months after treatment. Based on OCT images, we assessed central retinal thickness (CRT), presence of the epiretinal membrane, and serous retinal detachment (SRD), as well as status of the external limiting membrane and ellipsoid zone. RESULTS At baseline, mean aniseikonia was - 1.0 ± 2.5%, ranging from - 11.0 to + 6.0%. Nine out of 50 patients had micropsia (18%), one had macropsia (2%), and 40 had no aniseikonia (80%). After 6 months of treatment, mean aniseikonia was - 0.7 ± 1.5%, ranging from - 4.5 to + 3.5%. BCVA significantly improved after treatment (P < 0.001), but aniseikonia did not change (P = 0.73). In patients with BRVO who had micropsia (≤ - 2.0%) at baseline, mean aniseikonia significantly improved from - 4.8 ± 3.3% to - 0.9 ± 1.4% (P < 0.05). Aniseikonia after treatment significantly correlated with BCVA (P < 0.05) and the presence of SRD at baseline (P < 0.05). CONCLUSION Majority of eyes with aniseikonia in BRVO had micropsia. The BCVA as well as the micropsia improved following treatment with IVR for BRVO. BCVA and the presence of SRD were predictors of post-treatment aniseikonia.
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Hanumunthadu D, Lescrauwaet B, Jaffe M, Sadda S, Wiecek E, Hubschman JP, Patel PJ. Clinical Update on Metamorphopsia: Epidemiology, Diagnosis and Imaging. Curr Eye Res 2021; 46:1777-1791. [PMID: 33825600 DOI: 10.1080/02713683.2021.1912779] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: To discuss the pathophysiology of metamorphopsia, its characterisation using retinal imaging and methods of assessment of patient symptoms and visual function.Methods: A literature search of electronic databases was performedResults: Metamorphopsia has commonly been associated with vitreomacular interface disorders (such as epiretinal membrane) and has also regularly been noted in diseases of the retina and choroid, particularly age-related macular degeneration and central serous chorioretinopathy. Developments in optical coherence tomography retinal imaging have enabled improved imaging of the foveal microstructure and have led to the localisation of the pathophysiology of metamorphopsia within the retinal layers of the macula. Alteration of alignment of inner and outer retinal layers at various retinal loci has been identified using multimodal imaging in patients with metamorphopsia in a range of conditions. Although the Amsler Grid assessment of metamorphopsia is a useful clinical indicator, new emerging methods of metamorphopsia assessment with psychophysical tests such as M-CHARTS and preferential hyperacuity perimetry, have been developed.Conclusions: It appears that there is a complex relationship between visual acuity and metamorphopsia symptoms that vary between retinal conditions. Although metamorphopsia has traditionally been challenging to measure in the clinic, advances in technology promise more robust, easy-to-use tests. It is possible that home assessment of metamorphopsia, particularly in conditions such as age-related macular degeneration, may help to guide the need for further clinic evaluation and consideration of treatment.
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Affiliation(s)
- Daren Hanumunthadu
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | | | - Myles Jaffe
- Innova Medical Communications, LLC, Tustin, California, USA
| | - Srinivas Sadda
- Doheny Eye Institute, University of California, Los Angeles, California, USA
| | - Emily Wiecek
- Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Jean Pierre Hubschman
- Retina Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA
| | - Praveen J Patel
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
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CORRELATION BETWEEN MACULAR MICROSTRUCTURES AND ANISEIKONIA AFTER IDIOPATHIC EPIRETINAL MEMBRANE REMOVAL. Retina 2021; 40:1160-1168. [PMID: 30932997 DOI: 10.1097/iae.0000000000002530] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To analyze the correlation between preoperative measurements of macular microstructures and aniseikonia after epiretinal membrane removal. METHODS This retrospective study included 32 eyes of 32 patients who underwent epiretinal membrane surgery and were followed up for 12 months. Spectral-domain optical coherence tomography was used to measure the thicknesses of the ganglion cell layer-inner plexiform layer, inner nuclear layer (INL), and outer retinal layer in macular microstructures. The new aniseikonia test was used to measure vertical and horizontal aniseikonia scores. RESULTS There was a significant decrease in central macular thickness and ganglion cell layer-inner plexiform layer thickness at 6 and 12 months postoperatively (all P < 0.001). Vertical aniseikonia scores, horizontal aniseikonia scores, and INL and outer retinal layer thicknesses did not show significant changes. Vertical aniseikonia scores and horizontal aniseikonia scores were significantly associated with INL thicknesses of each meridian at each follow-up time point (all P < 0.05). Preoperative vertical and horizontal INL thicknesses were correlated with vertical aniseikonia scores and horizontal aniseikonia scores at 12 months postoperatively (P = 0.014 and P = 0.002, respectively). CONCLUSION Aniseikonia values did not change after epiretinal membrane removal and were associated with INL thickness before and after surgery. Thus, preoperative INL thickness could be used as a predictor of surgical prognosis in epiretinal membrane patients.
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Laíns I, Wang JC, Cui Y, Katz R, Vingopoulos F, Staurenghi G, Vavvas DG, Miller JW, Miller JB. Retinal applications of swept source optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Prog Retin Eye Res 2021; 84:100951. [PMID: 33516833 DOI: 10.1016/j.preteyeres.2021.100951] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 02/08/2023]
Abstract
The advent of optical coherence tomography (OCT) revolutionized both clinical assessment and research of vitreoretinal conditions. Since then, extraordinary advances have been made in this imaging technology, including the relatively recent development of swept-source OCT (SS-OCT). SS-OCT enables a fast scan rate and utilizes a tunable swept laser, thus enabling the incorporation of longer wavelengths than conventional spectral-domain devices. These features enable imaging of larger areas with reduced motion artifact, and a better visualization of the choroidal vasculature, respectively. Building on the principles of OCT, swept-source OCT has also been applied to OCT angiography (SS-OCTA), thus enabling a non-invasive in depth-resolved imaging of the retinal and choroidal microvasculature. Despite their advantages, the widespread use of SS-OCT and SS-OCTA remains relatively limited. In this review, we summarize the technical details, advantages and limitations of SS-OCT and SS-OCTA, with a particular emphasis on their relevance for the study of retinal conditions. Additionally, we comprehensively review relevant studies performed to date to the study of retinal health and disease, and highlight current gaps in knowledge and opportunities to take advantage of swept source technology to improve our current understanding of many medical and surgical chorioretinal conditions. We anticipate that SS-OCT and SS-OCTA will continue to evolve rapidly, contributing to a paradigm shift to more widespread adoption of new imaging technology to clinical practice.
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Affiliation(s)
- Inês Laíns
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Jay C Wang
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Ying Cui
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA; Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Raviv Katz
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Filippos Vingopoulos
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA
| | - Giovanni Staurenghi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", University of Milan, Italy
| | - Demetrios G Vavvas
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Joan W Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Harvard Retinal Imaging Lab, Boston, MA, USA.
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Ng H, Vermeer KA, van Meurs JC, La Heij EC. Visual Acuity Inadequately Reflects Vision-Related Quality of Life in Patients After Macula-Off Retinal Detachment Surgery. Invest Ophthalmol Vis Sci 2021; 61:34. [PMID: 32805003 PMCID: PMC7441472 DOI: 10.1167/iovs.61.10.34] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose To determine the impact of postoperative visual function on the vision-related quality of life (VRQoL) in patients after anatomically successful surgery for macula-off rhegmatogenous retinal detachment (RRD) and to propose a classification to grade the extent of macular detachment using preoperative optical coherence tomography (OCT) scans. Methods This prospective study evaluated 48 patients. At 12 months after surgery, visual function assessments were as follows: metamorphopsia (M-CHARTS), aniseikonia (New Aniseikonia Test), best corrected visual acuity (BCVA) (Early Treatment Diabetic Retinopathy Study [ETDRS]), low contrast BCVA (10% ETDRS), color vision (Hardy Rand Rittler), and stereopsis (Titmus Fly). VRQoL was assessed by the National Eye Institute Visual Functioning Questionnaire-25 (NEIVFQ-25). Associations between visual function parameters and NEIVFQ-25 scores were evaluated. Preoperative OCT-scans were classified into six stages according to the extent of macular detachment based on an ETDRS-grid: incomplete perifoveal detachment (1), incomplete parafoveal detachment (2), incomplete foveal detachment (3), complete foveal detachment (4), complete parafoveal detachment (5), and complete perifoveal detachment (6). Results General vision and driving were the lowest scoring categories. General vision had the strongest correlation with low contrast BCVA (r = −0.41, P = 0.002), while driving had the strongest correlation with stereopsis (r = −0.39, P = 0.008). All macular detachments were graded stage 3 or beyond. Patients with stage 3 macular detachments had the highest visual function values compared to the other stages. The highest percentage of patients with metamorphopsia, aniseikonia and BCVA>0.1 logMAR was found in stages 5 and 6. Conclusions Macula-off RRD particularly affects general vision and driving. The extent of macular detachment is a potential predictor for visual function and can be graded using the proposed classification.
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Affiliation(s)
- Heijan Ng
- Rotterdam Ophthalmic Institute, Rotterdam, the Netherlands
| | | | - Jan C van Meurs
- The Rotterdam Eye Hospital, Vitreoretinal Surgery, Rotterdam, the Netherlands
| | - Ellen C La Heij
- The Rotterdam Eye Hospital, Vitreoretinal Surgery, Rotterdam, the Netherlands
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Monocular and binocular visual parameters associated to vision-related quality of life in patients with epiretinal membrane: a prospective cohort. Graefes Arch Clin Exp Ophthalmol 2021; 259:1723-1730. [DOI: 10.1007/s00417-020-05064-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/24/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022] Open
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Krarup T, Nisted I, Christensen U, Kiilgaard JF, Cour M. Monocular and binocular end-points after epiretinal membrane surgery and their correlation to patient-reported outcomes. Acta Ophthalmol 2020; 98:716-725. [PMID: 32323909 DOI: 10.1111/aos.14449] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/28/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE This study evaluates current available endpoints for epiretinal membrane (ERM) surgery and examine their correlation to patient reported outcomes (PRO). METHODS Retrospective study including 38 eyes of 38 patients who underwent cataract extraction and subsequent vitrectomy for idiopathic ERM. The fellow eye was phakic with good visual acuity. The registered outcomes were monocular and binocular visual acuity, stereoacuity, M-chart metamorphopsia score, aniseikonia and aniseikonia tolerance range (ATR). Two questionnaires were completed: the convergence insufficiency symptom survey and Visual Function Questionnaire (VFQ-39). RESULTS Median total aniseikonia was 11% (range 0-35). There was a statistically significant correlation between the mean total M-chart score of the study eye and VFQ-Near (Spearman rho: VFQ-Near: -0.54, p < 0.01). There was no correlation between the best corrected visual acuity (BCVA) of the project eye, binocular BCVA, stereoacuity, ATR or mean total aniseikonia and PRO (Spearman p-values > 0.05). There was no correlation between mean total aniseikonia and mean total M-chart score (Spearman rho: 0.21 p = 0.26). There was a large variation between the mean total M-chart scores and questionnaire results. CONCLUSION The mean total M-chart score is currently the best end-points to predict PRO of ERM surgery; however, it is possible to have high M-chart values and have no visual complaints.
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Affiliation(s)
- Therese Krarup
- Department of Ophthalmology Rigshospitalet‐Glostrup Glostrup Denmark
| | - Ivan Nisted
- Institute for Clinical Medicine Aarhus University Faculty of Health Sciences Aarhus Denmark
| | - Ulrik Christensen
- Department of Ophthalmology Rigshospitalet‐Glostrup Glostrup Denmark
| | | | - Morten Cour
- Department of Ophthalmology Rigshospitalet‐Glostrup Glostrup Denmark
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Ng H, La Heij EC, Andrinopoulou ER, van Meurs JC, Vermeer KA. Smaller Foveal Avascular Zone in Deep Capillary Plexus Is Associated with Better Visual Acuity in Patients after Macula-off Retinal Detachment Surgery. Transl Vis Sci Technol 2020; 9:25. [PMID: 33024618 PMCID: PMC7521173 DOI: 10.1167/tvst.9.10.25] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 07/26/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To associate the change in the foveal avascular zone (FAZ) and vessel density (VD) with final best corrected visual acuity (BCVA) in eyes after macula-off rhegmatogenous retinal detachment surgery, and to investigate the evolution of FAZ and VD during 12 months of follow-up. Methods We prospectively evaluated 47 patients with macula-off rhegmatogenous retinal detachment and healthy fellow eyes. At 1.5, 3.0, 6.0, and 12.0 months postoperatively, optical coherence tomography angiography scans were obtained from both eyes on a 3.0 × 3.0 mm macula-centered grid. En face images of the superficial vascular plexus, intermediate capillary plexus and deep capillary plexus were used to quantify FAZ and VD. BCVA was assessed with ETDRS-charts (logarithm of the minimal angle of resolution). At 12 months postoperatively, the association between the change in optical coherence tomography angiography parameters and visual function in study eyes was evaluated using the Spearman correlation coefficient. We calculated the BCVA difference and the percentage difference of FAZ and VD between the study and control eye. The evolution of FAZ and VD was investigated with linear mixed-effects models with nested random effects (eyes nested within patients). Results At 12 months postoperatively, FAZ difference of the deep capillary plexus and BCVA difference were correlated (P = 0.0004, rs = 0.5). Furthermore, there was no evidence that FAZ and VD changed during follow-up. Conclusions Although FAZ and VD remained stable during 12 months after surgery for macula-off rhegmatogenous retinal detachment, a smaller FAZ in the deep capillary plexus is associated with better BCVA. Translational relevance Reduction in FAZ area may be caused by angiogenesis to counteract ischemia, therefore therapeutic stimulation of angiogenesis could be beneficial to visual recovery.
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Affiliation(s)
- Heijan Ng
- Rotterdam Ophthalmic Institute, Rotterdam, the Netherlands
| | - Ellen C La Heij
- The Rotterdam Eye Hospital, Vitreoretinal Surgery, Rotterdam, the Netherlands
| | | | - Jan C van Meurs
- The Rotterdam Eye Hospital, Vitreoretinal Surgery, Rotterdam, the Netherlands.,Erasmus Medical Center, Department of Ophthalmology, Rotterdam, the Netherlands
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EN FACE IMAGE–BASED ANALYSIS OF RETINAL TRACTION CAUSED BY EPIRETINAL MEMBRANE AND ITS RELATIONSHIP WITH VISUAL FUNCTIONS. Retina 2020; 40:1262-1271. [DOI: 10.1097/iae.0000000000002569] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fukuyama H, Ishikawa H, Komuku Y, Araki T, Kimura N, Gomi F. Comparative analysis of metamorphopsia and aniseikonia after vitrectomy for epiretinal membrane, macular hole, or rhegmatogenous retinal detachment. PLoS One 2020; 15:e0232758. [PMID: 32384099 PMCID: PMC7209121 DOI: 10.1371/journal.pone.0232758] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 04/21/2020] [Indexed: 11/29/2022] Open
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.
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Affiliation(s)
- Hisashi Fukuyama
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Hiroto Ishikawa
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yuki Komuku
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Takashi Araki
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Naoki Kimura
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Fumi Gomi
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
- * E-mail:
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Okamoto F, Morikawa S, Sugiura Y, Hoshi S, Hiraoka T, Oshika T. Preoperative aniseikonia is a prognostic factor for postoperative stereopsis in patients with unilateral epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2020; 258:743-749. [PMID: 32080768 DOI: 10.1007/s00417-020-04625-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/03/2020] [Accepted: 02/10/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To investigate stereopsis and other visual functions in patients with unilateral epiretinal membrane (ERM) and to identify vision-related parameters affecting stereopsis. METHODS This prospective study included 63 consecutive patients who were scheduled to undergo vitrectomy for unilateral idiopathic ERM. We examined stereopsis (Titmus Stereo Test, TST; TNO stereotest, TNO), best-corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia, and degree of aniseikonia preoperatively and 6 months postoperatively. RESULTS Preoperatively, we observed significant correlation between TST scores and other vision-related parameters except severity of metamorphopsia and between TNO score and all the vision-related parameters. Multiple regression analysis showed that preoperative TST and TNO scores were significantly associated with the degree of aniseikonia (both P < 0.01). ERM surgery significantly improved stereopsis, BCVA, contrast sensitivity, and metamorphopsia, but not aniseikonia. Postoperatively, TST was significantly associated with BCVA, and TNO showed association with BCVA and aniseikonia. Postoperative TST and TNO scores showed significant correlation with preoperative aniseikonia (P < 0.005 and P < 0.001, respectively). CONCLUSIONS Impairment of stereopsis in patients with unilateral ERM was considered to be due to retinally induced aniseikonia. Aniseikonia did not improve by surgery, and preoperative aniseikonia can be a prognostic factor for postoperative stereopsis.
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Affiliation(s)
- Fumiki Okamoto
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Shohei Morikawa
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yoshimi Sugiura
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Sujin Hoshi
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tetsuro Oshika
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
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Zhao L, Wu H. Evaluation of aniseikonia with an auto-stereoscopic smartphone. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:642. [PMID: 31930043 PMCID: PMC6944609 DOI: 10.21037/atm.2019.10.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 10/16/2019] [Indexed: 03/28/2024]
Abstract
BACKGROUND An auto-stereoscopic smartphone can produce 3D images without the need for the viewer to wear glasses. The purpose of this study was to evaluate whether this technology could be utilized to measure aniseikonia. METHODS A 2K auto-stereoscopic smartphone was used to imitate the Awaya new aniseikonia test. In test 1, four pairs of lenses combined with a trial frame were used to create 4 different magnification rates in 10 subjects. In test 2, 40 subjects whose anisometropia was higher than 2.00D were recruited. RESULTS No significant difference between the results of the Awaya new aniseikonia test and auto-stereoscopic smartphone test (Wilcoxon signed-rank test: test 1, P=0.85; test 2, P=0.53). Bland-Altman plots showed that the difference between the two tests was ≤1% in both tests 1 and 2. CONCLUSIONS An auto-stereoscopic smartphone can be an effective tool for evaluating aniseikonia.
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Affiliation(s)
- Lingzhi Zhao
- Department of Medical Equipment, the Second Hospital of Jilin University, Changchun 130041, China
| | - Huang Wu
- Department of Optometry, the Second Hospital of Jilin University, Changchun 130041, China
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Ichikawa Y, Imamura Y, Ishida M. Inner Nuclear Layer Thickness, a Biomarker of Metamorphopsia in Epiretinal Membrane, Correlates With Tangential Retinal Displacement. Am J Ophthalmol 2018; 193:20-27. [PMID: 29890161 DOI: 10.1016/j.ajo.2018.06.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 05/31/2018] [Accepted: 06/01/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE To examine correlations of inner nuclear layer (INL) thickness with metamorphopsia and tangential retinal displacement in epiretinal membrane (ERM). DESIGN Retrospective, consecutive, interventional case series. METHODS Setting: Institutional study. PATIENT POPULATION Fifty eyes of 50 patients undergoing epiretinal membrane surgery. OBSERVATION PROCEDURES M-CHARTS were used to measure metamorphopsia. Inner nuclear layer (INL) thickness and outer retinal layer (ORL) thickness in the macula and distances between the intersections of 2 sets of retinal vessels situated vertically or horizontally were measured in Spectralis optical coherence tomography and infrared images. MAIN OUTCOME MEASURES Correlations of INL and ORL thicknesses with M-CHARTS scores and distances of retinal displacement. RESULTS Preoperative INL thickness significantly correlated with preoperative and postoperative metamorphopsia scores at 3 months (Spearman correlation coefficient: P = .036 and P = .003, respectively). The baseline INL thickness and its change at 3 months significantly correlated with the postoperative vertical retinal displacements at 3 months (P < .001 for both). Preoperative and postoperative ORL thicknesses were not correlated with preoperative and postoperative metamorphopsia scores at any periods. CONCLUSIONS INL thickness is a useful biomarker to evaluate metamorphopsia and appears to be determined by tangential retinal displacement in ERM. Structural changes of the inner retinal layer, which cause Müller cells to be distorted, play a more important role for generation of metamorphopsia than outer retina. Our results provide evidence for the theory that Müller cell functions as an optic fiber in humans.
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Affiliation(s)
- Yoshikazu Ichikawa
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan; Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Yutaka Imamura
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan.
| | - Masahiro Ishida
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan
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