Vision-related parameters that affect stereopsis in patients with macular hole

Abstract

This study evaluated stereopsis and other visual functions in patients with idiopathic macular hole (MH), and sought to identify vision-related parameters that affect stereopsis. In this prospective, consecutive, comparative study, 39 eyes of 39 patients with unilateral idiopathic MH were included. At baseline and at 6 months after MH surgery, we evaluated stereopsis, with the Titmus stereo test (TST) and TNO stereotest (TNO), best-corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia, as assessed using M-CHARTS, and extent of aniseikonia, by the new aniseikonia test. Preoperative stereopsis (log) in patients with MH were 2.72 ± 0.53 (range 1.9-4.1) in the TST and 2.82 ± 0.65 (range 1.8-3.9) in the TNO. Preoperative TST was significantly correlated with letter contrast sensitivity (p < 0.05), but not with the other visual functions. TNO showed significant correlation with letter contrast sensitivity (p < 0.05) and aniseikonia (p < 0.005). Preoperative TNO was associated with aniseikonia by multivariate analysis (p < 0.005). MH surgery significantly improved stereopsis, BCVA, letter contrast sensitivity, metamorphopsia, and aniseikonia. Postoperative TST and TNO was significantly associated with BCVA by multivariate analysis. Deterioration of stereopsis in MH patients is associated with contrast sensitivity and the degree of aniseikonia. Macular hole (MH) causes not only blurred vision, but also various other visual impairments, such as metamorphopsia 1-7 , aniseikonia 8,9 , and stereopsis 10-12. Visual acuity improves in many patients after successful MH surgery 13,14 , whereas some patients still complain of disturbances in visual function after surgery. Stereopsis is the ability to perceive depth of field based on the disparity between the images formed by the two eyes-it is the most advanced visual function. Wheatstone invented the stereoscope and discovered that, if areas on the retina of both eyes that are separated horizontally were stimulated simultaneously, stereopsis could occur 15. Visual acuity is the most commonly considered vision-related parameter that affects stereopsis. Stereopsis worsens even when visual impairment is present in only one eye 16-20. In addition, some other factors are known to affect stereopsis, such as aniseikonia 21-23 , pupil size 23,24 , eye dominance 21,25 , and accommodation 20,26. Several studies have investigated stereopsis in retinal disorders, including MH 10-12 and epiretinal membrane (ERM) 12,27 , and after retinal detachment (RD) surgery 28 , all of which impaired stereopsis. However, the details of vision-related parameters that cause those disturbances of stereopsis in retinal disorders remain unknown. The purpose of the present study was to evaluate stereopsis and other visual function parameters, including visual acuity, contrast sensitivity, metamorphopsia, and aniseikonia in patients with unilateral MH, and to identify vision-related parameters that affect stereopsis. Methods We conducted this prospective, consecutive, comparati...

<p>Stereopsis After Unilateral Macular Hole Surgery with Internal Limiting Membrane Peeling</p>

“…More recently, Okamoto et al investigated the pre-and postoperative stereopsis in patients with MH. 24 The mean preoperative TST value was 2.72 ± 0.53 log units and it improved significantly after surgery to 2.19 ± 0.35 log units (P <0.0001). 24 The mean TNO stereoacuity value also improved from 2.82 ± 0.65 log units to 2.32 ± 0.41 log units (P <0.0001).…”

“…24 The mean preoperative TST value was 2.72 ± 0.53 log units and it improved significantly after surgery to 2.19 ± 0.35 log units (P <0.0001). 24 The mean TNO stereoacuity value also improved from 2.82 ± 0.65 log units to 2.32 ± 0.41 log units (P <0.0001). 24 The TST value in our cohort was 1.81 ± 0.24 log units which was better than that in their patients although the patients tested with TNO were similar.…”

“…24 The mean TNO stereoacuity value also improved from 2.82 ± 0.65 log units to 2.32 ± 0.41 log units (P <0.0001). 24 The TST value in our cohort was 1.81 ± 0.24 log units which was better than that in their patients although the patients tested with TNO were similar. This discrepancy may be due to the better BCVA in our patients.…”

Relationship Between Stereopsis and Vision-Related Quality of Life Following Intravitreal Ranibizumab Injections for Central Retinal Vein Occlusion

“…The impairment in the visual function of one eye is known to compromise stereopsis. Prior studies have investigated the disturbance of stereopsis in patients with unilateral retinal diseases, including RD [6,7], ERM [8,9], MH [10,11], and BRVO [12]. The stereopsis in patients with ERM was 2.35 on the TST and 2.84 on the TNO [9], 2.7 on the TST and 2.8 on the TNO in patients with MH [11], and 2.72 on the TST and 2.72 on the TNO in patients with BRVO [12].…”

“…Previous experimental studies have shown that blurred vision in one eye affects stereopsis [1][2][3][4][5]. Several studies have reported the impairment of stereopsis in unilateral retinal diseases such as retinal detachment (RD) [6,7] epiretinal membrane (ERM) [8,9], macular hole (MH) [10,11], and branch retinal vein occlusion (BRVO) [12]. Moreover, the stereopsis of patients with these conditions were worse than those of normal participants even following successful treatment [6,9,11,12].…”