Qantification of the metamorphopsia

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In patients with macula disease, visual disturbance and central scotoma are common symptoms. Metamorphopsia is also one of the most important symptoms for evaluating their visual functions. However, it was difficult to evaluate the degree of metamorphopsia quantitatively.In patients with metamorphopsia, a straight line projected onto the retina is recognized as an irregular or curved line. When a dotted line is used and the dot interval changes from fine to coarse, metamorphopsia decreases and finally disappears. Based on this phenomenon, we developed a new metamorphopsia chart (M-CHARTS^<TM>). We also displayed these dotted lines on a high resolution CRT monitor for low vision patients.We applied this method to normal subjects and patients with metamorphopsia due to epiretinal membranes (ERM), macula holes, central serous retinopathy and age-related macular degeneration. We compared the metamorphopsia scores to fundus photographs and images of scanning laser ophthalmoscope (SLO). We a … More lso evaluated the reproducibility of the metamorphopsia scores using M-CHARTS^<TM> in normal subjects and the patients with ERM, central serous retinopathy and age-related macular degeneration. The examinations of M-CHARTS^<TM> were repeated 3 times for each eye.The reproducibility of the metamorphopsia scores was sufficient for clinical use. In patients with ERM, the scores obtained from the horizontal dotted lines were larger than those of the vertical lines in advanced stages of ERM. We investigated the relationship between the contraction of ERM and metamorphopsia scores using M-CHARTS^<TM> . There was a relationship between the direction of the retinal contractions and the direction of the metamorphopsia. In patient with macula hole, there was a relationship between the metamorphopsia scores and the diameter of the fluid cuff rather than the diameter of the macular hole. Using the CRT monitor, the metamorphopsia scores were almost same as the M-CHARTS^<TM> . We were able to display larger and higher contraction stimulus on the CRT monitor, which was useful for low vision patients whose visual acuity were less than 0.1.In conclusion, M-CHARTS^<TM> is a simple and useful method for the detection and follow-up of the metamorphopsia in patients with macular disease. Less