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Retinal misregistration and effect of surgery on its improvement in patients with epiretinal membrane
Arash Mirzaei1, Mohammad Reza Akbari1, Abdulrahim Amini2
1Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Purpose:
To evaluate the prevalence of retinal misregistration, that is, misalignment of retinal elements that affect central and peripheral fusion, and the effect of surgery in patients with epiretinal membrane (ERM).
Methods:
This prospective interventional case-series was performed on 32 patients with symptomatic ERM with the complaint of binocular diplopia or decreased visual acuity. After the diagnosis of ERM, optotype frame, synoptophore, and lights on-off tests were used to evaluate retinal misregistration. Patients with severe symptoms underwent surgery and were followed for 3 months.
Results:
Of the 32 patients, 6 (19%) had preoperative diplopia. Optotype frame, synoptophore, and lights on-off tests had positive results in 20 (63%), 19 (63%), and 11 (34%) cases, respectively. Of the 6 diplopia cases, 5 showed positive results in all 3 tests and 1 was positive on optotype frame and synoptophore testing. Of the 26 cases without diplopia, 15 (58%) showed positive results in at least one test, including 6 (23%) in all three tests, 6 (23%) in two tests, and 3 (12%) in only one test. Ten patients underwent surgery. Postoperatively, all patients had negative lights on-off test, but optotype frame and synoptophore tests were negative in eight patients (80%). Two cases (20%) had postoperative diplopia, including 1 case with postoperative new-onset diplopia.
Conclusions:
The prevalence of retinal misregistration was higher than the rate of diplopia. Surgery improved diplopia and results of tests of retinal misregistration.
Insights
Retinal misregistration, a misalignment affecting vision, is more common than diplopia in epiretinal membrane (ERM) patients. Surgery effectively improved both misregistration and diplopia symptoms.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Surgical Interventions
Background:
- Epiretinal membrane (ERM) can cause visual disturbances affecting fusion.
- Retinal misregistration, a misalignment of retinal elements, impacts both central and peripheral vision.
Purpose of the Study:
- To determine the prevalence of retinal misregistration in patients with symptomatic ERM.
- To assess the efficacy of surgical intervention for ERM in resolving retinal misregistration and associated symptoms like diplopia.
Main Methods:
- A prospective case-series study involving 32 patients with symptomatic ERM.
- Diagnostic tools included optotype frame, synoptophore, and lights on-off tests to evaluate retinal misregistration.
- Surgical intervention was performed on patients with severe symptoms, followed by a 3-month observation period.
Main Results:
- Preoperative diplopia was present in 19% of patients; however, retinal misregistration was detected in a higher percentage (up to 63%) across various tests.
- Post-surgery, the lights on-off test was negative in all patients, and 80% showed negative results on optotype frame and synoptophore tests.
- Two patients (20%) experienced postoperative diplopia, with one case being new-onset.
Conclusions:
- Retinal misregistration occurs more frequently than diplopia in ERM patients.
- Surgical treatment for ERM demonstrates a positive impact on reducing diplopia and improving objective measures of retinal misregistration.
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