J Korean Ophthalmol Soc.  2010 Apr;51(4):552-557. 10.3341/jkos.2010.51.4.552.

An Analysis of Metamorphopsia Using Preferential Hyperacuity Perimeter Following Macular-off RRD Surgical Repair

• Park HJ
• Lee SW
• Kim KH
• Lee JH
• Lee JE
• Oum BS

• KMID: 2213398
• DOI: http://doi.org/10.3341/jkos.2010.51.4.552

Abstract

PURPOSE
To determine the efficacy of using the preferential hyperacuity perimeter (PHP) for the analysis of metamorphopsia following macular-off rhegmatogenous retinal detachment (RRD) surgical repair.
METHODS
PHP examination was performed in those who complained of metamorphopsia after successful surgical reattachment of RRD. The subjective symptoms were evaluated based on a scale, ranging from 0 to 10, and were compared with the results of PHP examination. Patients age, duration of retinal detachment, pre and post-operative visual acuity, postoperative presence of subretinal fluid (SRF), surgical methods, presence of epiretinal membrane, and time from operation to PHP test were analyzed to find the correlation with the PHP results.
RESULTS
Of the 19 eyes included in this study, nine eyes were found to have a hyperacuity defect upon PHP examination. In this group, the subjective level of metamorphopsia was significantly worse (p<0.01), the age was significantly higher (p=0.02), and SRF persisted in the macula more frequently at two months postoperatively (p=0.04), as compared to those without the defect. There were no significant differences in the other factors.
CONCLUSIONS
Subjectively severe metamorphopsia after surgery for RRD could be confirmed objectively using PHP. In the case of older patients and persistent submacular fluid, metamorphopsia would develop more frequently due to displacement of the photoreceptors in the process of reattachment.

Keyword

Metamorphopsia; Preferential hyperacuity perimeter; Rhegmatogenous retinal detachment

MeSH Terms

Displacement (Psychology)
Epiretinal Membrane
Eye
Humans
Retinal Detachment
Subretinal Fluid
Vision Disorders
Visual Acuity

Figure

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  Figure 1. (A) 54-year-old-man with inferior visual field defect in the left eye for 2 weeks, underwent scleral buckling for rhegmatogenous retinal detachment (case No. 7). After the operation, he complained of metamorphopsia. (B) Post-operative 7 months, hyperacuity defects were demonstrated in the preferential hyperacuity perimeter. The location of the hyperacuity defect is corresponded to the boundary of detachment in the macula.

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  Figure 2. (A) Normal attached retina. Red Xs represent photoreceptors located in normal position. (B) Total macular ‐off retinal detachment. Green Xs represent photoreceptors displaced position after reattachment. (C) Partial mac-ular‐off retinal detachment. Blue line indicates the boundary of the detachment.

Reference

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