Correlations between M-CHARTS and PHP Findings and Subjective Perception of Metamorphopsia in Patients with Macular Diseases
Correlations between M-CHARTS and PHP Findings and Subjective Perception of Metamorphopsia in Patients with Macular Diseases
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DOI：
10.1167/iovs.09-3535
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发表时间：
2011-01-01
影响因子：
4.4
通讯作者：
Shimomura, Yoshikazu
中科院分区：
文献类型：
--
作者：
Arimura, Eiko;Matsumoto, Chota;Shimomura, Yoshikazu
目的.通过M-CHARTS和PreView PHP（PHP）评估患者对视物变形的主观感知与视物变形的临床测量之间的相关性。作者设计了一个10个项目的调查问卷，重点是变形视物症的症状，并验证其有效性与Rasch分析。M-CHARTS测量了检测视物变形所需的虚线的最小视角，PHP使用超敏度功能进行检测。研究对象为39例特发性视网膜前膜（ERM）患者、22例特发性黄斑裂孔（M-hole）患者、19例年龄相关性黄斑变性（AMD）患者和51例健康对照者。Rasch分析建议消除一个问题。在ERM中，9项问卷评分与M-CHARTS评分显著相关（r = 0.59; P = 0.0004），但与M-hole无关;在AMD中，9项问卷评分与PHP结果显著相关（r = -0.29; P = 0.04），但与ERM无关。80%的水平M-CHARTS评分较高的ERM患者主观上更经常地感知到水平变形。M-CHARTS在ERM（89% vs. 42%）和AMD（74% vs. 68%）中的敏感性均优于PHP，在健康对照中的特异性更好（100% vs. 71%）。Rasch分析表明，目前的问卷形式更适合于中度至重度的视物变形病例，而不是轻度病例。该问卷似乎是一个有效的评估患者的主观感觉的视物变形，并可用于补充临床测量的视物变形的黄斑疾病患者的M-CHARTS和PHP。（Invest Ophthalmol维斯科学。2011; 52：128-135）DOI：10.1167/iovs.09-3535
PURPOSE. To assess the correlations between a patient's subjective perception of metamorphopsia and the clinical measurements of metamorphopsia by M-CHARTS and PreView PHP (PHP).METHODS. The authors designed a 10-item questionnaire focusing on the symptoms of metamorphopsia and verified its validity with a Rasch analysis. M-CHARTS measured the minimum visual angle of a dotted line needed to detect metamorphopsia, and PHP used the hyperacuity function for detection. Subjects were 39 patients with idiopathic epiretinal membrane (ERM), 22 patients with idiopathic macular hole (M-hole), 19 patients with age-related macular degeneration (AMD), and 51 healthy controls.RESULTS. Rasch analysis suggested the elimination of one question. The nine-item questionnaire score significantly correlated to the M-CHARTS score in ERM (r = 0.59; P = 0.0004) but not in M-hole and to the PHP result in AMD (r = -0.29; P = 0.04) but not in ERM. Eighty percent of ERM patients with greater horizontal M-CHARTS score subjectively perceived horizontal metamorphopsia more often. M-CHARTS showed better sensitivities than PHP in both ERM (89% vs. 42%) and AMD (74% vs. 68%) and better specificity (100% vs. 71%) in healthy controls. Rasch analysis indicated that the present form of the questionnaire is better suited for moderate to severe cases of metamorphopsia than for mild cases.CONCLUSIONS. The questionnaire appears to be a valid assessment of patient subjective perception of metamorphopsia and can be used to supplement the clinical measurements of metamorphopsia by M-CHARTS and PHP in patients with macular diseases. (Invest Ophthalmol Vis Sci. 2011; 52: 128-135) DOI: 10.1167/iovs.09-3535