PURPOSE.To follow the changes in the metamorphopsia, visual acuity, and OCT parameters after epiretinal membrane (ERM) removal.METHODS. The study included 49 eyes of 49 patients with an ERM who underwent vitrectomy and membrane peeling. The changes in the best-corrected visual acuity (BCVA), metamorphopsia, and central foveal thickness (CFT) were evaluated at baseline and 1, 3, 6, 9, and 12 months postoperatively. M-CHARTS were used to quantify metamorphopsia. RESULTS.The mean BCVA, metamorphopsia scores for horizontal lines (MH) and vertical lines (MV), and CFT improved significantly at 12 months after surgery (P < 0.001). The baseline BCVA, MH score, and MV score were significantly correlated with the corresponding BCVA, MH score, and MV score at 12 months after surgery (P < 0.01). The MH and MV scores at 12 months was significantly correlated with the BCVA at 12 months (P < 0.01), and the baseline MV score was significantly correlated with the BCVA at 12 months (P < 0.05). The MH score but not the MV score was significantly correlated with the CFT at baseline and 12 months (P < 0.05).CONCLUSIONS. The preoperative BCVA, MH score, and MV score were prognostic factors for the corresponding postoperative BCVA, MH score, and MV score. These results suggest that surgery for ERM should be considered before severe reduction in the BCVA or the degree of metamorphopsia. In addition, the preoperative MV score was a prognostic factor for postoperative BCVA. The MH score but not the MV score was correlated with the CFT preoperatively and postoperatively. (Invest Ophthalmol Vis Sci. 2012;53:3592-3597) DOI:10.1167/ iovs.12-9493 P atients with an idiopathic epiretinal membrane (ERM) often suffer from metamorphopsia, which impairs the quality of vision even when the conventional visual acuity is relatively good. To resolve these visual difficulties, these eyes commonly undergo vitrectomy with the removal of the ERM. Despite a successful removal of an ERM and an improvement of the visual acuity, the patient's quality of vision may not be completely normal mainly because of residual metamorphopsia. Thus, it is essential to evaluate the visual outcome in terms of the quality of vision as well as by the visual acuity. Okamoto et al.1,2 demonstrated that the changes in metamorphopsia but not the visual acuity were significantly associated with changes in the 25-item National Eye Institute Visual Function Questionnaire composite score on the quality of vision after ERM surgery. Therefore, assessing not only the visual acuity but also the severity of metamorphopsia is important when deciding the timing of the ERM surgery and for evaluating the postoperative quality of vision.Amsler charts have been widely used for detecting metamorphopsia, 3 but it is difficult to quantify the severity of the metamorphopsia. Some investigators have evaluated metamorphopsia by the numbers of distorted squares on the Amsler charts 4 or a laser grid generated by a scanning laser ophthalmoscope, 5 but these findings represent the range rather than the ...

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PurposeTo determine the correlation between the changes in metamorphopsia in daily life environment and the M-CHARTS scores after epiretinal membrane (ERM) removal, and to determine the criterion for determining whether clinically significant changes in the metamorphopsia score have occurred in M-CHARTS.MethodsWe studied 65 eyes undergoing vitrectomy for unilateral ERM. Self-administered questionnaires were used to examine the metamorphopsia in their daily life. The degree of metamorphopsia was determined by M-CHARTS. The receiver operating characteristic curve was used to determine the best predictor of the changes in metamorphopsia in daily life. To determine the reproducibility of the M-CHARTS score, another set of 56 eyes with ERM was tested twice on two different days.ResultsThe postoperative changes in the logarithm of the M-CHARTS score was defined as M2-value. The area under the receiver operating characteristic curve for the M2-value as a predictor of the changes in metamorphopsia in daily life was larger than area under the receiver operating characteristic curve obtained for any other parameter. The optimal cutoff value was −0.4. The 95% limits of agreement between test and retest measurements had a reproducibility of ±0.3 logarithm of the M-CHARTS score. Taking into account not only the reproducibility but also the consistency with the subjective changes, we determined the criterion for clinically significant changes in the M-CHARTS scores as a change of the M2-value by ≥0.4.ConclusionEvaluating the changes in the M-CHARTS scores in logarithmic form is favorable not only theoretically but also from the perspective of consistency with the subjective changes.