Vision-related quality of life and visual function in patients undergoing vitrectomy, gas tamponade and cataract surgery for macular hole

Abstract

Aim: To evaluate the relationship between vision-related quality of life (VR-QOL) and visual function in patients undergoing vitrectomy, gas tamponade and cataract surgery for macular hole (MH). Methods: The 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was self-administered by 32 patients with MH (age 66.2 (SD 5.4) years) preoperatively and at 3 months postoperatively. Clinical data were collected, including logarithm of minimum angle of resolution (logMAR) best corrected visual acuity (BCVA), severity of metamorphopsia and letter contrast sensitivity. The severity of metamorphopsia was evaluated by the M-Charts. MH index was measured using optical coherence tomography. The presence and severity of cataract were graded using the Lens Opacities Classification System III reference standards. Multiple regression analysis was performed to investigate the relationship between various explanatory variables and VFQ-25 questionnaire scores. Explanatory variables tested were the severity of metamorphopsia, visual acuity, letter contrast sensitivity, MH index and grade of cataract. Results: Vitrectomy for MH significantly improved VFQ-25 composite score as well as subscale scores, including general vision, near activities, distance activities, social functioning, mental health and dependency (p,0.05, Wilcoxon signed-rank test). Multiple regression analysis revealed that, both preoperatively and postoperatively, the severity of metamorphopsia had a significant correlation with VFQ-25 composite score (p,0.05), whereas other explanatory variables did not. In addition, changes in the severity of metamorphopsia was the single variable that was significantly related to changes in VFQ-25 composite score (p,0.01). Conclusion: Vitrectomy for MH significantly improved VR-QOL. The severity of metamorphopsia was significantly associated with both preoperative and postoperative VR-QOL.

Vision-Related Quality of Life and Visual Function After Retinal Detachment Surgery

“…Similar scores as in RRD surgery have been observed after macula hole surgery (mean VFQ-25 CS 82.4) and epiretinal membrane surgery (83.3) but much lower scores in age-related macular degeneration surgery (54.4). 9,12,16 In this study, VR QOL was at a lower level in patients with RRD than in normal controls even after successful reattachment surgery. In previous studies, a mean VFQ-25 CS after RRD surgery of approximately 80 has been reported.…”

Vitrectomy for Idiopathic Epiretinal Membrane in Elderly Patients: Surgical Outcomes and Visual Prognosis

“…2,7,8,[22][23][24] Moreover, studies investigating visionrelated quality of life in patients undergoing vitrectomy for ERM and other ocular conditions demonstrated a significant improvement in vision and in quality of life. [25][26][27][28] However, it is a common observation that old age is sometimes a barrier for the acceptance of surgery for various ocular conditions. This is probably particularly true for conditions such as ERM, which is often monocular and associated with only moderate visual deterioration, while surgery is associated with a risk for significant complications such as retinal detachment or endophthalmitis.…”

Metamorphopsia: An Overlooked Visual Symptom

“…No significant relationship was found between metamorphopsia scores and visual acuity [72]. Usually after surgery for a macular hole, a decrease in metamorphopsia was reported [73,74]. Krøyer et al [73] suggested that both tangential displacement of the PRs and the eversion of the PRs (due to inner margin eversion) are responsible for metamorphopsia.…”

“…Metamorphopsia is a common symptom in ERM, macular holes, retinal detachment, and even after successful retinal surgery [13,46,47,48,49,68,69,70,71,72,73,74,75]. Shinoda et al [46 ]correlated the severity of metamorphopsia determined with modified Amsler charts with the subjective score in patients with ERM.…”