1.Metamorphopsia change and influence factors before and after idiopathic epiretinal membrane surgery
Xida LIANG ; Yi WANG ; Limei LIU ; Meng GAO ; Yanping YU ; Zengyi WANG ; Jinqiu CHEN ; Xinxin LIU ; Wu LIU
Chinese Journal of Experimental Ophthalmology 2019;37(1):21-28
Objective To investigate the changes of metamorphopsia between before and after surgery in the patients with idiopathic epiretinal membrane and its influence factors.Methods A series cases observitional study included 39 eyes of 39 patients with idiopathic epiretinal membrane.Follow-up was carried out at 1 week before surgery and 3,6 months after surgery respectively.M-chart was used to quantify the severity of metamorphopsia (M-score).EDTRS visual chart was used to quantify best corrected visual acuity (BCVA) (converted to LogMAR).Central subfield thickness (CST),central foveal volumn (CV),cube average thickness (CAT),central foveal thichness (CFT),ganglion cell layer (GCL) thickness,inner nuclear layer (INL) thickness,outer nuclear layer (ONL) and outer plexiform layer (OPL) thickness,the integrity of external limiting membrane,ellipsoid zone and interdigitation zone were analyzed by using spectral domain-optical coherence tomography (OCT).This study protocol was approved by Ethic Committee of Beijing Tongren Hospital (No.TRECKY-012).Written informed consent was obtained from each subject before surgery.Results Mean M-score was significantly decreased from 0.8 (0.3,1.1) before surgery to 0.5 (0.2,0.8) at 3 months after surgery,with a significant difference between the two time points (Z=-2.013,P=0.044).Mean M-score was 0.6(0.2,0.8) at 6 months after surgery,which was not significantly different in comparison with before surgery and 3 months after surgery (Z =-1.873,P =0.061;Z =-0.288,P =0.773).Compared with before surgery,the horizontal M-score was significantly decreased 3 months and 6 months after surgery (Z =-2.329,P =0.020;Z =-2.858,P =0.004).No significant difference was found in vertical M-score among before surgery and 3,6 months after surgery (all at P>0.05).The BCVA was improved from 0.40 (0.30,0.66) before surgery to 0.20 (0.06,0.42) 3 months after surgery and declined to 0.30 (0.10,0.52) at 6 months after surgery,and significant differences were obtained between 3 months after surgery and before surgery or 6 months after surgery (Z =-4.087,P<0.001;Z =-2.235,P =0.025).Compared with before surgery,the BCVA in cataract combined with vitrectomy operative group was significantly improved in 3 months and 6 months after surgery (Z=-2.613,P=0.009;Z=-2.466,P=0.014) and the BCVA in only vitrectomy group was significantly improved at 3 months after surgery but decreased 6 months after surgery,showing significant differences between 3 months after surgery and before surgery or 6 months after surgery (Z =-3.104,P =0.002;Z =-3.464,P =0.001).Preoperative M-score was positively correlated with preoperative BCVA,preoperative CST or preoperative CFT (rs =0.384,P =0.016;rs =0.585,P<0.001;rs =0.601,P<0.001).No correlation was found between BCVA with GCL,INL or ONL + OPL thickness.Horizontal M-score was positively correlated with CST,postoperative CV and postoperative CAT (rs=0.322,P=0.045;rs=0.340,P=0.034;rs =0.336,P=0.036),and no correlation was found between horizontal M-score and BCVA,CFT,GCL thickness,INL thickness,ONL+OPL thickness in 6 months after surgery.The vertical M-score and mean M-score were not correlated with OCT parameters in 6 months after surgery.The mean M-score was positively correlated with preoperative mean M-score,preoperative CST,preoperative CV,preoperative CAT in 6 months after surgery (rs =0.589,P<0.001;rs =0.330,P =0.040;rs =0.404,P =0.011;rs =0.410,P =0.009).In addition,and no significant correlation between mean M-score and preoperative BCVA,CFT,GCL thickness,INL thickness,ONL+OPL thickness.Multivariate stepwise linear regression showed that preoperative M-score was a predictor of postoperative M-values (adjusted R2 =0.211,P =0.002).Conclusions Most metamorphopsia can be alleviated after idiopathic epiretinal membrane surgery.The residue metamorphopsia after surgery probably is correlated with preoperative metamorphopsia and CFT.
2.Relationship of mean retinal sensitivity with vision-related quality of life in patients with idiopathic macular hole
Zengyi WANG ; Xida LIANG ; Yanping YU ; Jing WANG ; Wu LIU
Chinese Journal of Experimental Ophthalmology 2019;37(1):35-39
Objective To evaluate the relationship of retinal sensitivity (MS) with vision-related quality of life in patients with idiopathic macular hole (IMH).Methods A prospective cohort study was performed in this study.Thirty-one monocular IMH patients were enrolled in Beijing Tongren Hospital from May to September of 2017.Vision-related quality of life (VR-QoL) was analyzed in 31 patients with National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) (Chinese version),and MS in the affected eye and the fellow eye in these patients was detected by Microperimeter-3.MS and best corrected visual acuity (BCVA) between the affected eye and the fellow eye were compared.The correlations among BCVA,age,MS,minimum macular hole diameter,composite scores and subscales score were evatuateds.This study protocol was approved by Ethic Committee of Beijing Tongren Hospital.This study complied with Declaration of Helsinki.Results There were significant correlations between composite scores and MS in the affected eye and the fellow eye (affected eye:ρ=0.484,P=0.006;fellow eye:ρ=0.387,P =0.031).Significante correlations were shown in near activities (affected eye:ρ =-0.353,P =0.048;fellow eye:ρ =0.352,P =0.048) and distance activities (affected eye:ρ =0.496,P =0.004;fellow eye:ρ =0.415,P =0.015).No obvious correlations were shown between VR-QoL and BCVA or minimum hole diameter.The correlation between composite scores and the MS in the affected eye was the most strong.Conclusions MS can reflect the retinal function in patients of IMH more widely.The correlations VR-QoL and MS is correlated in the affected eye and fellow eye in patients of monocular IMH,however,patient's VR-QoL dependes more on the affected eye.IMH can violate the patient's near and distance activities.