Multimodal imaging of eyes with metamorphopsia after vitrectomy for rhegmatogenous retinal detachment

Purpose: To assess the retinal features in eyes with postoperative metamorphopsia (POM) following rhegmatogenous retinal detachment (RRD) repair using multimodal imaging (MMI). Methods: In this cross-sectional; case-control study, patients after successful RRD repair following 25-gauge vitrectomy, clear vitreous cavity, and corrected distance visual acuity (CDVA)>20/200 were categorized using Amsler chart: cases with POM and controls without POM. MMI was performed on swept-source platform (Triton, Topcon Inc) and the confocal scanning laser ophthalmoscope system (Spectralis HRA, Heidelberg). The measures assessed were CDVA, morphological features on optical coherence tomography, autofluorescence, and multicolor imaging (MCI). Results: Thirty-nine eyes were included in each group. Cases had greater number of eyes with total RRD (P = 0.029) preoperatively; abnormal foveal contour (P = 0.036), ellipsoid zone (EZ) disruption (P < 0.001) and poorer postoperative CDVA (P = 0.046) as compared to controls. Outer retinal folds and retinal shift (unintentional translocation of retina after reattachment surgery for RRD) did not differ significantly between the groups (P = 0.48 and 0.35, respectively). On MCI, the distribution of detected ERM was similar between the groups (P = 0.25). Postoperative CDVA was significantly worse in eyes with POM. Conclusion: POM is affected by extent of RRD, postoperative foveal contour, and EZ status but not by retinal shift.