Metamorphopsia and Optical Coherence Tomography Findings After Pars Plana Vitrectomy with Gas Tamponade

Abstract

Background: Rhegmatogenous retinal detachment (RRD) affects 1 in 10,000 populations per year. It is characterized by neurosensory retinal detachment from the retinal pigment epithelium due to a retinal break. Retinal detachment is present in 0.5 to 1% eyes after cataract surgery. Objective: To evaluate metamorphopsia and its association with Optical Coherence Tomography (OCT) findings after Rhegmatogenous Retinal Detachment surgery by Pars Plana Vitrectomy using gas tamponade (Sf6). Methods: Prospective, interventional study was carried out in Ophthalmology unit, Dow University of Health Sciences and Dr. Ruth K. M. Pfau Civil Hospital, Karachi from 22nd February 2021 to 1st August 2021. Thirty patients aged between 30 to 60 years, either gender and pseudophakic that underwent Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment using 20% sulfur hexafluoride tamponade were included. Metamorphopsia was assessed using Amsler grid and OCT was performed to evaluate retinal images 2 months postoperatively. Fisher's exact test was used for association between metamorphopsia and OCT findings. Results: The mean age of the patients was 47.43 ± 8.39 years. At 2 months of surgery, metamorphopsia was present in 16/30 (53.3%) patients of which 11/16 (69%) had abnormal macula on OCT (disruption of photoreceptor junction (4 eyes, 26%), epiretinal membrane (2 eyes, 13%), subretinal fluid (2 eyes, 13%), retinal folds (1 eye, 6%), cystoid macular edema (1 eye, 6%) and macular hole (1 eye, 6%) and 5/ 16 (31%) exhibited a normal macula. In the non-metamorphopsia group of 14 patients, 3/14 (21%) showed abnormal macula and 11/14 (79%) had normal macula on OCT (p = 0.014; Fisher's exact test) Conclusion: Metamorphopsia after pars plana vitrectomy with gas tamponade is more common in patients with abnormal retinal morphology on OCT.