Quantifying metamorphopsia with M-CHARTS in patients with idiopathic macular hole

Abstract

PurposeThe purpose of this study was to determine the degree of metamorphopsia using M-CHARTS™ in patients with idiopathic macular hole before and after pars plana vitrectomy and internal limiting membrane (ILM) peeling.Patients and methodsThe records of 22 eyes of 22 patients with a full-thickness macular hole who underwent pars plana vitrectomy and ILM peeling were reviewed. All patients underwent a complete ophthalmic examination including spectral-domain optical coherence tomography (OCT). Horizontal metamorphopsia (MH) and vertical metamorphopsia (MV) scores were determined using M-CHARTS at the same time. The time course of changes in metamorphopsia and the relationship between best-corrected visual acuity (BCVA) and OCT parameters were assessed.ResultsSealing of the macular hole was noted in all eyes after surgery. BCVA improved significantly from 1 month after surgery (P<0.001). The MV score was significantly higher than the MH score before surgery (P<0.05) and improved significantly from 1 month after surgery (P<0.03). The MH score improved significantly at 6 months after surgery (P<0.001). The postoperative MV and MH scores became closer to one another from 1 month after surgery. Moreover, the MV score was higher than the MH score at all postoperative assessments. There was a significant correlation between the MV and MH scores at all follow-up assessments. There was no significant correlation between BCVA and the MV or MH score at any follow-up assessment.ConclusionThe satisfaction of the patients with macular hole after surgery cannot be necessarily measured by BCVA alone, because M-scores were not correlated to BCVA in postoperative evaluation. Therefore, evaluation of the MV and MH scores can be an independent treatment outcome in addition to BCVA.

Vertical and Horizontal M-Charts and Microperimetry for Assessment of the Visual Function in Patients after Vitrectomy with ILM Peeling due to Stage 4 Macular Hole

“…Furthermore, the VM scores were consistently higher than the corresponding HM scores, and there was a trend—the higher the VM, the higher the HM scores at all assessment times. It is a similar result to the previous study [6, 17, 18].…”

“…Most of the authors [7, 19, 20] present only general score of M-charts. Wada et al analyse both HM and VM scores [6].…”

“…The test is carried out in the vertical and horizontal directions separately. The M-charts result was considered positive if the metamorphopsia score was more than 0 [6].…”

“…The Amsler test is very simple, cheap, and consists of evenly (every 5 mm) spaced horizontal and vertical lines. The Amsler test is widely used to evaluate metamorphopsia, but it does not provide quantification of the severity of metamorphopsia [6]. M-charts (Inami, Japan) developed in 1999 by Matsumoto et al enable evaluation of the degree of metamorphopsia quantitatively in patients with macular disease [7].…”

Evaluation of pre- and post-surgery reading ability in patients with epiretinal membrane: a prospective observational study

“…The metamorphopsia scores measured using the M-CHARTS included both MV and MH, as measured by presenting the chart in vertical and horizontal orientations, respectively. We evaluated by type 1 M-charts, which uses a single dotted line and is designed for patients with a fixation point such as epiretinal membrane or age-related macular degeneration [21]. As with the above-described MNREAD-J charts, the evaluation was performed with the patient sitting at a distance of 30 cm from the chart under appropriate near correction.…”