| Purpose After scleral buckling, it is a common clinical phenomenon that metamorphopsia occurs with reattched retina and affects patients' visual quanlity greatly. Since the causes are not clear, there are no effective treatment currently. Our study is to observe the macular structure and function of patients underwent scleral buckling and complained about metamorphopsia, so as to evaluate the causes of these metamorphopsia and guide their clinical cares.Methods Totally 79 subjects (79eyes) of metamorphopsia with retina reattched but without eye position changed were studied on 2 weeks, 2months, 6months and 1 year after scleral buckling. We used Amsler grid to record metamorphopsia, ophthalmoscope, fundus fluorescence angiography (FFA)as well as optical coherence tomography (OCT) to observe macular structure and multifocal electroretinography (mfERG) to detect macular function.Results 51 subjects (64.56%) of totally 71 subjects complained about metamorphopsia. 44 subjects (metamorphopsia group 35 subjects, non-metamorphopsia group 9 subjects) underwent OCT and FFA. We used OCT to observe 35 subjects of metamorphopsia. 31 subjects (88.57%) of them had abnormal macular structures, including 7 categories: neuroepithelium detachment 23 subjects, pigment epithelium detachment 1 subject, macular edema 2 subjects, cystoid macular edema 1 subject, macular membrane 1 subject, neuroepithelium detachment with subretinal deposits 2 subjects and neuroepithelium detachment with vitreous traction 1 subject. We also used FFA to observe those 35 subjects of metamorphopsia. 6 subjects(17.14%) of them had abnormal macular structures, including: neuroepithelium detachment 4 subjects, pigment epithelium detachment 1 subject and cystoid macular edema 1 subject. In non-metamorphopsia group, OCT displayed abnormal macular structures in 2 subjects (22.22%): neuroepithelium detachment 1 subject, pigment epithelium detachment l subject. FFA didn't show any abnormal structure in non-metamorphopsia group.42 subjects, 10 subjects and 5 subjects in the total of 79 subjects were followed up and underwent　OCT 2 months, 6 months and 1 year after surgery respectively. 2 months after surgery, 2 subjects recovered, 20 subjects relieved, 4 subjects kept normal structure and 2 subjects worsened in 28 metamorphopsia subjects. OCT illustrated as following: (1) 17 neuroepithelium detachment subjects: 1 subject recovered, 13 subjects relieved, 1 subject turned to cystoid macular edema , 2 subjects turned to macular membrane; (2) 4 subjects of normal macular unchanged; (3)Another 7 subjects with abnormal macular relieved or recovered. In 14 non-metamorphopsia subjects, no one complained about metamorphopsia 2 months after surgery. OCT of these 14 subjects displayed: 9 subjects kept normal macular structure, 2 subjects of neuroepithelium detachment recovered, 3 subjects of neuroepithelium detachment relieved. 6 months after surgery, 10 subjects underwent OCT. They were made up of 9 metamorphopsia subjects and 1 non-metamorphopsia subject. In the former, 3 subjects of neuroepithelium detachment changed as following: 1 subject relieved, 1 subject recovered, 1 subject turned to macular membrane. 3 subjects of pigment epithelium detachment relieved, 3 subjects of normal structure unchanged. In the latter of non-metamorphopsia, macular structure kept normal. 1 year after surgery, 5 subjects complained of metamorphopsia underwent　OCT．Their results showed: 2 subjects of macular membrane unchanged, with persistent metamorphopsia; 2 subjects of pigment epithelium detachment and 1 subject of cystoid macular edema recovered ,with metamorphopsia relieved or disappeared.23 subjects (metamorphopsia 14 subjects, non-metamorphopsia 9 subjects) in the total of 79 subjects underwent mfERG 2 weeks after surgery. There were no significant differences of macular a-wave latency, amplitude, b-wave latency, amplitude and b-wave mean reaction density between metamorphopsia group and non-metamorphopsia group. 10 subjects underwent mfERG on 2 weeks and... |
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