Quantification of changes in metamorphopsia and retinal contraction in eyes with spontaneous separation of idiopathic epiretinal membrane

Abstract

Background To quantify changes in metamorphopsia and retinal contraction in eyes with idiopathic epiretinal membrane (ERM) before and after a spontaneous separation of ERM. Methods Among 92 eyes of 92 patients with idiopathic ERM who were followed up at our hospital, 5 eyes of 5 patients had experienced a spontaneous separation of ERM during the follow-up period. Patient's metamorphopsia was assessed horizontally and vertically by a metamorphopsia chart developed by our group, M-CHARTS, to obtain the horizontal (MH) and vertical (MV) metamorphopsia scores. Difference in the scores before and after the membrane separation represents change in patient's metamorphopsia. Changes in retinal contraction were also evaluated horizontally and vertically with our original software for fundus image analysis. The difference between M-CHARTS scores and distances of retinal vessel movements with before and after membrane separation were measured. Results All five subjects showed a decrease in the retinal contraction. Improved visual acuity was observed in three subjects, and no change was seen in the other two. Four subjects obtained better metamorphopsia scores after the membrane separation, while the other one was not detected with metamorphopsia by M-CHARTS either before or after the separation. In subjects with an improved MV, horizontal retinal movement

A Case of Secondary Epiretinal Membrane Spontaneous Release

“…ERM spontaneous separation is rare (3–6%) [7–9], and it is essential to observe this process in the dynamics. Spontaneous ERM release was described in association with toxoplasma uveitis, eye trauma, and laser surgery (pan-retinal photocoagulation and YAG-laser capsulotomy) [7, 10].…”

“…Spontaneous ERM release was described in association with toxoplasma uveitis, eye trauma, and laser surgery (pan-retinal photocoagulation and YAG-laser capsulotomy) [7, 10]. The case of the secondary ERM separation associated with branch retinal vein occlusion is presented in the literature for the first time.…”

Quantitative assessment of metamorphopsia using M-charts and Amsler tests in patients with non-treated central serous chorioretinopathy

“…OCT is an accurate tool for qualitative and quantitative assessment of the macular structure. This device might show the precise structural changes of the macular region, like pigment epithelial detachment (PED), retinal pigment epithelium (RPE) irregularities, subretinal fluid, and CRT -distance between the anterior (internal limiting membrane) and posterior (retinal pigment epithelium) highly reflected boundaries of the retina [10]. The M-charts are superior to the Amsler grid in detecting metamorphopsia in patients with retinal disease, for example CSCR, AMD, or ERM.…”

“…Although Amsler's charts do not quantify the degree of distortion, the locations and shapes of distortion can be detected. M-charts can quantify the degree of distortion but cannot describe the shapes and locations of the subject's metamorphopsia [10]. The M-charts provide more information than the Amsler charts in regard to the horizontal and vertical lines.…”

“…If a patient recognises the straight line as an irregular or curved line, more coarse dotted lines are shown to the patient in the following test. When the patient recognises a dotted line as straight, its visual angle is considered as his/her metamorphopsia score -a minimum visual angle of a dotted line needed to detect metamorphopsia [10]. Next, the M-charts are rotated by 90° and the same test is performed using horizontal lines.…”