Preoperative aniseikonia is a prognostic factor for postoperative stereopsis in patients with unilateral epiretinal memb
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Preoperative aniseikonia is a prognostic factor for postoperative stereopsis in patients with unilateral epiretinal membrane Fumiki Okamoto 1 & Shohei Morikawa 1 & Yoshimi Sugiura 1 & Sujin Hoshi 1 & Takahiro Hiraoka 1 & Tetsuro Oshika 1 Received: 23 December 2019 / Revised: 3 February 2020 / Accepted: 10 February 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To investigate stereopsis and other visual functions in patients with unilateral epiretinal membrane (ERM) and to identify vision-related parameters affecting stereopsis. Methods This prospective study included 63 consecutive patients who were scheduled to undergo vitrectomy for unilateral idiopathic ERM. We examined stereopsis (Titmus Stereo Test, TST; TNO stereotest, TNO), best-corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia, and degree of aniseikonia preoperatively and 6 months postoperatively. Results Preoperatively, we observed significant correlation between TST scores and other vision-related parameters except severity of metamorphopsia and between TNO score and all the vision-related parameters. Multiple regression analysis showed that preoperative TST and TNO scores were significantly associated with the degree of aniseikonia (both P < 0.01). ERM surgery significantly improved stereopsis, BCVA, contrast sensitivity, and metamorphopsia, but not aniseikonia. Postoperatively, TST was significantly associated with BCVA, and TNO showed association with BCVA and aniseikonia. Postoperative TST and TNO scores showed significant correlation with preoperative aniseikonia (P < 0.005 and P < 0.001, respectively). Conclusions Impairment of stereopsis in patients with unilateral ERM was considered to be due to retinally induced aniseikonia. Aniseikonia did not improve by surgery, and preoperative aniseikonia can be a prognostic factor for postoperative stereopsis. Keywords Aniseikonia . Stereopsis . Epiretinal membrane . Prognostic factor . Vitrectomy
Introduction Stereopsis is the ability to perceive the depth of field based on the disparity in the images formed by the two eyes; it is the most advanced visual function. Wheatstone invented the stereoscope and discovered that if the areas on the retina of both the eyes, separated horizontally, were stimulated simultaneously, stereopsis could occur [1]. Visual acuity is the most popular vision-related parameter that affects stereopsis. Clinical experiments show that stereopsis gets worse enough even when visual impairment occurs in one eye [2–6]. In addition, some other factors, such as aniseikonia [7–9], pupil
* Fumiki Okamoto [email protected] 1
Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan
size [9, 10], eye dominance [7, 11], and accommodation [6, 12], are known to affect stereopsis. Epiretinal membrane (ERM) is known to cause not only blurred vision but also various visual impairments such as metamorphopsia [13–19], aniseikonia [2
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