Metamorphopsia before and after full-thickness macular hole surgery

Abstract

Purpose: We quantified the degree and dynamics of metamorphopsia changes in patients subjected to full-thickness macular hole surgery.

Material/methods: This prospective interventional case series included 10 eyes of 10 patients with full-thickness macular hole (mean age 66.2±6.0 years). The patients underwent a complete ophthalmological examination including SD-OCT. The severity of metamorphopsia (expressed as M-score) was evaluated with M-CHARTS. 20-gauge pars plana vitrectomy with trypan blue staining, internal limiting membrane peeling and 20% sulphur hexafluoride tamponade was performed. Time course of metamorphopsia changes and their relation to best corrected visual acuity (BCVA) and OCT parameters were assessed.

Results: Significant but not total M-score decrease was observed one month postoperatively (0.72±0.44 vs. 0.50±0.36, z=-2.207, p=0.0353, power=0.26, pre- vs. post-op), with subsequent stabilization (0.41±0.41 three months and 0.37±0.44 six months post-op). The differences between M-score one month, three months and six months postoperatively were not significant. Baseline M-score correlated significantly with postoperative values at three follow-ups (rho=0.853, 0.715, 0.847; p<0.05 for all; power=0.94, 0.58, 0.79). Baseline M-score did not correlate with macular hole dimensions (including basis p=0.154, minimal diameter p=0.051 or height of the border p=0.700). No correlation between M-score and the following parameters was found either pre- or postoperatively: BCVA, central foveal thickness, central subfield macular thickness and central subfield macular volume.

Conclusions: In patients with successfully operated full-thickness macular hole, M-score decreased as early as one month postoperatively and was stable afterwards. The baseline M-score was a prognostic factor for the postoperative M-score. M-score turned out to be independent from BCVA and macular hole dimensions.

Keywords: BCVA; M-CHARTS; M-score; Macular hole; Metamorphopsia; OCT.