Correlation between Quantification of Metamorphopsia and Optical Coherence Tomography Findings in Patients with Epiretinal Membrane

Patrick Kim; Sung Yong Park

doi:10.3341/jkos.2016.57.4.588

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Kim and Park: Correlation between Quantification of Metamorphopsia and Optical Coherence Tomography Findings in Patients with Epiretinal Membrane

Original Article

J Korean Ophthalmol Soc 2016;57(4):588-594.

Published online: 3 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.4.588

Correlation between Quantification of Metamorphopsia and Optical Coherence Tomography Findings in Patients with Epiretinal Membrane

Patrick Kim, MD, Sung Yong Park, MD

Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea

Address reprint requests to Sung Yong Park, MD Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, #31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Korea Tel: 82-41-570-2114, Fax: 82-41-592-3810 E-mail: 81381@schmc.ac.kr

Received 17 December 2015 Revised 3 February 2016 Accepted 6 March 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the quantification of metamorphopsia with a novel method that uses Monpack One (Metrovision, Perenchies, France) and to compare the relationship between metamorphopsia score and spectral-domain optical coherence tomography (SD-OCT) findings in patients with epiretinal membrane (ERM).

Methods

This study included 37 eyes of 35 patients with idiopathic ERM. We examined the patients using SD-OCT and quantified the degree of metamorphopsia using the Monpack One. On the topographic map of the Early Treatment Diabetic Retinopathy (ETDRS) grid, central retinal thickness at the fovea (1 mm), and parafovea (3 mm) was measured with the SD-OCT software. The correlation between these factors was analyzed. We repeated the metamorphopsia test twice in 22 eyes of 11 healthy subjects in order to calculate intraclass correlation coefficients (ICCs) and evaluate the reproducibility and reliability of the new metamorphopsia test.

Results

On the ETDRS grid, the retinal thickness (µm) of the central, superior, inferior, nasal, and temporal subfields was 495 ± 102, 428 ± 98, 454 ± 78, 434 ± 83, and 463 ± 95, respectively. The mean total metamorphopsia score was 24.8 ± 13.9, while those for the superior, inferior, nasal, and temporal subfields were 14.7 ± 9.1, 15.1 ± 8.6, 15.9 ± 8.9, and 14.6 ± 8.6, respectively. Linear regression analysis revealed that total metamorphopsia score was significantly related to central retinal thickness (p = 0.01). Moreover, each subfield of parafoveal retinal thickness positively correlated with metamorphopsia subfield score (p < 0.01 −0.023). The ICCs for the metamorphopsia tests of the healthy individuals showed almost perfect repeatability (>0.9) in all subfields.

Conclusions

The degree of metamorphopsia in ERM could be quantified objectively on each subfield using the Monpack One metamorphopsia test. The degree of metamorphopsia significantly correlated with retinal thickness measurements based on SD-OCT.

Keywords: Epiretinal membrane, Metamophopsia, Monpack One, Spectral domain optical coherence tomography

References

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Figure 1.

Small pattern of bars presented over a background grid during the metamorphopsia test.

Figure 2.

The metamorphopsia test software consists of tests in 21 different locations positioned every four degrees over the macular field. RE = right eye; LE = left eye.

Figure 3.

Correlation between total metamorphopsia score and CRT (μm). The CRT (μm) and total metamorphopsia score were significantly positively correlated (r = 0.635, p = 0.001). p-value was determined using linear regression analysis. CRT = central retinal thickness.

Figure 4.

Relationship between metamorphopsia score and retinal thickness in subjects with epiretinal membrane. Correlation between metamorphopsia score and retinal thickness (μm) in the (A) inferior subfield, (B) superior subfield, (C) temporal subfield, and (D) nasal subfield. (A) Significant positive correlation was found between retinal thickness of the inferior subfield and metamorphopsia score of the superior field (r = 0.469, p = 0.003). (B) Significant positive correlation between retinal thickness of the superior subfield and metamorphopsia score of the inferior field (r = 0.574, p < 0.001). (C) Significant positive correlation between retinal thickness of the temporal subfield and metamorphopsia score of the nasal field (r = 0.630, p = 0.001). (D) Significant positive correlation between retinal thickness of the nasal subfield and metamorphopsia score of the temporal field (r = 0.373, p = 0.001). p-value was determined using linear regression analysis.

Figure 5.

Clinical manifestations of a patient with epiretinal membrane. (A) Fundus photograph of a 49-year-old female with epiretinal membrane on the right eye. (B) Horizontal section scan showing epiretinal membrane. (C) Colored topographic map showing increased retinal thickening in the superior field. (D) Numeric value of ETDRS grid also showing increased superior thickening. (E) Metamorphopsia test results showed a higher score in the inferior than superior field. ETDRS = Early Treatment Diabetic Retinopathy.

Table 1.

Baseline characteristics of patients with idiopathic epiretinal membrane

Characteristics	Value
Number of eyes (subjects)	37 (35)
Sex (male:female)	16:21
Age (years)	64.44 ± 8.82
Visual acuity (log MAR)	0.50 ± 0.15
Refraction (S.E)	0.41 ± 2.60
Lens status (phakia : pseudophakia)	28:9

Values are presented as mean ± SD unless otherwise indicated. S.E = spherical equivalent; SD = standard deviation.

Table 2.

Retinal thickness (inner ring of ETDRS grid) and metamorphopsia score of patients with idiopathic epiretinal membrane

Subfield	Retinal thickness (μm)	Metamorphopsia score
Superior	428 ± 98	14.7 ± 9.1
Inferior	454 ± 78	15.1 ± 8.6
Nasal	434 ± 83	15.9 ± 8.9
Temporal	463 ± 95	14.6 ± 8.6

Values are presented as mean ± SD unless otherwise indicated. ETDRS = Early Treatment Diabetic Retinopathy; SD = standard deviation.

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