Accepted for/Published in: JMIR Perioperative Medicine
Date Submitted: May 27, 2024
Date Accepted: Mar 4, 2025
Date Submitted to PubMed: Mar 7, 2025
Quantification of Metamorphopsia using a Smartphone-based Hyperacuity Test in Patients with Idiopathic Epiretinal Membranes: Prospective Observational Study
ABSTRACT
Background:
Quality of vision in patients with idiopathic epiretinal membranes (iERM) is closely linked to the degree of distorted vision, called metamorphopsia.
Objective:
This study assessed the utility of a novel smartphone-based hyperacuity test (SHT) in quantifying metamorphopsia before and after surgical intervention for iERM, comparing it to a conventional printed chart.
Methods:
This prospective exploratory case study included 27 iERM patients with symptomatic metamorphopsia detected on the Amsler grid scheduled for vitrectomy with membrane peeling. The SHT (Alleye, Oculocare medical Inc., Zurich, Switzerland) and the horizontal (MH) and vertical (MV) M-chart (Inami & Co., Ltd., Tokyo, Japan) tests were performed three times before and three months after surgery. Pre- and postoperative metamorphopsia scores, changes in distance-corrected visual acuity (DCVA), optical coherence tomography (OCT) biomarkers and subjective perception of metamorphopsia were evaluated.
Results:
The mean SHT score significantly (r=.69, P<.001) improved from 55.2 ± 18.9 before surgery to 63.5 ± 16.3 after surgery while the improvement of the M-chart scores were insignificant (MH r=.37, P=.06; MV r=.18, P=.36). Pre- and postoperative SHT scores showed very weak and insignificant correlations with the MH, MV, and MH+MV scores. Both metamorphopsia tests showed good reliability (intraclass correlation coefficients >.75).
Conclusions:
The study showed that quantitative data provided by the SHT significantly improved postoperatively suggesting that patients with metamorphopsia due to iERM can benefit from surgery. Retrieval of metamorphopsia scores into individual examined retinal axes measured by the SHT would be of great value to prove if the insignificant correlation between the two tests may be explained by their discrepancy in examined retinal areas. Clinical Trial: ClinicalTrials.gov NCT05138315
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