Five-year changes in metamorphopsia and the association of outer retinal layers after vitrectomy for rhegmatogenous retinal detachment involving the macula

Abstract

To evaluate the 5-year changes in metamorphopsia and outer retinal morphology after vitrectomy for macula-off rhegmatogenous retinal detachment (RRD). We included 21 eyes from 21 patients with macula-off RRD who underwent pars plana vitrectomy. Metamorphopsia was quantified using M-CHARTS. Using spectral-domain optical coherence tomography, we assessed the risk factors for metamorphopsia severity 5 years after surgery. Metamorphopsia scores substantially improved from 1 month to 5 years postoperatively; however, they remained unchanged from 1 year to 5 years postoperatively. Overall, 11 (52.4%) patients had metamorphopsia 5 years postoperatively. The metamorphopsia scores in eyes with a continuous interdigitation zone (IZ) and ellipsoid zone at 5 years were considerably lower than those in eyes with a disrupted IZ. Multiple regression analysis revealed that the metamorphopsia score at 5 years was markedly associated with the score at 1 month and continuous IZ. No statistically significant change was observed in metamorphopsia scores after 1 year postoperatively, and > 50% of the patients had metamorphopsia at 5 years postoperatively. The improvement was associated with lower metamorphopsia scores at 1 month and continuous IZ at 5 years. Moreover, the study revealed that early metamorphopsia was a poor prognostic marker for long-term functional deficits.