Saleh Maher, Gauthier Anne-Sophie, Delbosc Bernard, Castelbou Marie
Ophthalmologica. 2018;240(3):121-128. doi: 10.1159/000486164. Epub 2018 May 29.
To determine the impact of metamorphopsia on quality of life after successful retinal detachment (RD) surgery and to determine which retinal changes are related to the most severe distortions.
This was a prospective, observational, consecutive study.
The study included 58 eyes of 58 consecutive patients who underwent successful RD surgery. At 6 months postoperatively, the incidence and severity of metamorphopsia were assessed by a quality-of-life questionnaire. Microstructure retinal changes were studied with spectral domain optical coherence tomography (OCT). The questionnaire score was compared with pre- and postoperative OCT findings.
Overall, 20 patients (34.5%) had metamorphopsia. Outer retinal folds (ORFs) and the macular status before surgery, together with postoperative ORFs and decrease in ellipsoid and/or interdigitation photoreceptor zone reflectivity, were identified as risk factors of developing metamorphopsia (relative risk, 1.7-4.8). The most severe visual distortions were associated with ORFs.
Metamorphopsia is a frequent occurrence after RD surgery and its impact on patients' quality of life appears to be limited. While it may be difficult to prevent photoreceptor loss occurring after surgery, limiting postoperative ORFs may be helpful in reducing their incidence.
确定成功进行视网膜脱离（RD）手术后，视物变形对生活质量的影响，并确定哪些视网膜变化与最严重的视觉扭曲有关。
这是一项前瞻性、观察性、连续性研究。
该研究纳入了58例连续接受成功RD手术患者的58只眼。术后6个月，通过生活质量问卷评估视物变形的发生率和严重程度。采用光谱域光学相干断层扫描（OCT）研究视网膜微观结构变化。将问卷得分与术前和术后OCT检查结果进行比较。
总体而言，20例患者（34.5%）出现视物变形。术前的视网膜外层褶皱（ORF）和黄斑状态，以及术后的ORF和椭圆体和/或指状交叉感光细胞区反射率降低，被确定为发生视物变形的危险因素（相对风险，1.7 - 4.8）。最严重的视觉扭曲与ORF有关。
视物变形是RD手术后的常见情况，其对患者生活质量的影响似乎有限。虽然术后可能难以预防感光细胞丢失，但限制术后ORF可能有助于降低其发生率。
