Metamorphopsia and vision-related quality of life among patients with age-related macular degeneration

To assess subjective and quantified metamorphopsia, as well as vision-related quality of life (QOL), in patients with age-related macular degeneration (AMD) to determine whether there is a correlation between quantified metamorphopsia and vision-related QOL in patients with AMD.

A cross-sectional study of patients with AMD. Patients who had a best-corrected visual acuity less than 20/200, vitreomacular adhesion, vitreomacular traction, epiretinal membrane, macular hole, macular edema by causes other than AMD, diabetic retinopathy, retinal detachment, previous retinal surgery, glaucoma, amblyopia, or strabismus were excluded. Subjective perceptions of metamorphopsia were captured by a validated 10-item questionnaire. M-CHARTS (Inami, Japan) was used to detect quantified metamorphopsia. Quantified metamorphopsia was scored horizontally and vertically. The mean values of 3 repeated examinations were used for data analysis. The 25-item National Eye Institute Visual Functioning Questionnaire (VFQ-25) was used to assess vision-related QOL.

Among 102 eyes with AMD, the most commonly reported subjective perception of metamorphopsia included lines of words on books, newspapers, or computer displays (45.1%), followed by frames of windows or bookshelves (22.6%), lines of tiles on bathroom wall (21.6%), and people's faces (18.6%). Eyes with wet AMD had significantly higher horizontal and vertical metamorphopsia scores compared with eyes with dry AMD (p < 0.0001). The higher horizontal metamorphopsia score and the higher vertical metamorphopsia score between the 2 eyes were both negatively correlated with the NEI VFQ-25 composite score (Spearman rank correlation r = -0.3207, p = 0.0010; Spearman rank correlation r = -0.3190, p = 0.0011).

In our study, the most common subjective metamorphopsia was distortion of lines of words on books, newspapers, or computer displays. Compared to eyes with dry AMD, those with wet AMD had higher quantified horizontal and vertical metamorphopsia. Between the 2 eyes, both the higher horizontal and vertical metamorphopsia scores were correlated with the NEI VFQ-25 composite score.