Comparative analysis of tabular and software methods of quantitative assessment of metamorphopsia

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BACKGROUND: Identifying and evaluating the severity of patients complaints of metamorphopsia is an important component of the pre- and postoperative management of patients with vitreomacular interface conditions. To diagnose metamorphopsia, the Amsler grid is used, which allows to detect changes, but does not allow to quantify them. The authors of this article have developed a special software program for quantitative evaluation of metamorphopsia.

AIM: The aim is to comparatively evaluate tabular and programmatic methods of metamorphopsia assessment.

MATERIALS AND METHODS: The study involved 36 patients (36 eyes) divided into two groups: “macular hole” (20 patients, 20 eyes) and “epiretinal fibrosis” (16 patients, 16 eyes). Quantitative assessment of metamorphopsia was performed by two methods: tabular — using printed tables, which are an analog of M-CHARTS, and software — using the developed computer program.

RESULTS: When comparing the integral parameters of the two methods using the Bland–Altman analysis, the results were highly comparable: the mean value of the difference between the PMs determined by the tabular and program methods was only –0.020°; the 95% confidence interval ranged from 0.277° to 0.235°, with 34 (94.4%) cases out of 36 falling within this range.

CONCLUSIONS: The program and tabular methods of metamorphopsia examination are interchangeable and provide reasonably accurate quantification of metamorphopsia. The developed program is available on-line (https://mntk.ru/specialists/nauka-sotr/diag_meta/) and can be recommended for widespread clinical use.

作者简介

Alexander Shpak

S.N. Fyodorov Eye Microsurgery Federal State Institution

Email: a_shpak@inbox.ru
ORCID iD: 0000-0003-0273-3307
SPIN 代码: 3253-4790

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, 59a Beskudnikovskii bulvar, Moscow, 127486

Alexey Zhuravlev

S.N. Fyodorov Eye Microsurgery Federal State Institution

编辑信件的主要联系方式.
Email: zhuravlevalexey96@gmail.com
ORCID iD: 0000-0002-6306-0428

graduate student

俄罗斯联邦, 59a Beskudnikovskii bulvar, Moscow, 127486

Flora Avakyan

S.N. Fyodorov Eye Microsurgery Federal State Institution

Email: avakyan.flora@yandex.ru
ORCID iD: 0000-0002-5250-3684

graduate student

俄罗斯联邦, 59a Beskudnikovskii bulvar, Moscow, 127486

Anton Kolesnik

S.N. Fyodorov Eye Microsurgery Federal State Institution

Email: kolesnik.doctor@gmail.com
ORCID iD: 0000-0002-6835-7204
SPIN 代码: 6910-1469

MD, Cand. Sci. (Medicine)

俄罗斯联邦, 59a Beskudnikovskii bulvar, Moscow, 127486

Svetlana Kolesnik

S.N. Fyodorov Eye Microsurgery Federal State Institution

Email: svkolesnik83@gmail.com
ORCID iD: 0000-0002-0939-024X
SPIN 代码: 9761-2754

MD, Cand. Sci. (Medicine)

俄罗斯联邦, 59a Beskudnikovskii bulvar, Moscow, 127486

Aik Avakyan

Tver State University

Email: avakyan.aik007@yandex.ru
ORCID iD: 0009-0002-9149-7552

student

俄罗斯联邦, Tver

参考

  1. Fung AT, Galvin J, Tran T. Epiretinal membrane: A review. Clin Exp Ophthalmol. 2021;49(3):289–308. doi: 10.1111/ceo.13914
  2. Matsumoto C, Arimura E, Okuyama S, et al. Quantification of metamorphopsia in patients with epiretinal membranes. Invest Ophthalmol Vis Sci. 2003;44(9):4012–4016. doi: 10.1167/iovs.03-0117
  3. Arndt C, Rebollo O, Séguinet S, et al. Quantification of metamorphopsia in patients with epiretinal membranes before and after surgery. Graefes Arch Clin Exp Ophthalmol. 2007;245(8):1123–1129. doi: 10.1007/s00417-006-0505-1
  4. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;327(8476):307–310. doi: 10.1016/S0140-6736(86)90837-8
  5. Arimura E, Matsumoto C, Nomoto H, et al. Correlations between M-CHARTS and PHP findings and subjective perception of metamorphopsia in patients with macular diseases. Invest Ophthalmol Vis Sci. 2011;52(1):128–135. doi: 10.1167/iovs.09-3535
  6. Wada I, Yoshida S, Kobayashi Y, et al. Quantifying metamorphopsia with M-CHARTS in patients with idiopathic macular hole. Clin Ophthalmol. 2017;11:1719–1726. doi: 10.2147/OPTH.S144981
  7. Arimura E, Matsumoto C, Okuyama S, et al. Quantification of metamorphopsia in a macular hole patient using M-CHARTS. Acta Ophthalmol Scand. 2007;85(1):55–59. doi: 10.1111/j.1600-0420.2006.00729.x
  8. Hillier RJ, Felfeli T, Berger AR, et al. The pneumatic retinopexy versus vitrectomy for the management of primary rhegmatogenous retinal detachment outcomes randomized trial (PIVOT). Ophthalmology. 2019;126(4):531–539. doi: 10.1016/j.ophtha.2018.11.014
  9. Kinoshita T, Imaizumi H, Miyamoto H, et al. Changes in metamorphopsia in daily life after successful epiretinal membrane surgery and correlation with M-CHARTS score. Clin Ophthalmol. 2015;9:225–233. doi: 10.2147/OPTH.S76847
  10. Nowomiejska K, Oleszczuk A, Brzozowska A, et al. M-CHARTS as a tool for quantifying metamorphopsia in age-related macular degeneration treated with the bevacizumab injections. BMC Ophthalmol. 2013;13:13. doi: 10.1186/1471-2415-13-13
  11. Wrzesińska D, Nowomiejska K, Nowakowska D, et al. Vertical and horizontal M-CHARTS and microperimetry for assessment of the visual function in patients after vitrectomy with ILM peeling due to stage 4 macular hole. J Ophthalmol. 2019;2019:4975973. doi: 10.1155/2019/4975973
  12. McGowan G, Yorston D, Strang NC, Manahilov V. D-CHART: A novel method of measuring metamorphopsia in epiretinal membrane and macular hole. Retina. 2016;36(4):703–708. doi: 10.1097/IAE.0000000000000778

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1. JATS XML
2. Fig. 1. M-CHARTS (Inami & Co., Ltd, Japan)

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3. Fig. 2. A software method for evaluating metamorphopsia. Screen view with one of the test images. Further details are explained in the text

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4. Fig. 3. Bland–Altman analysis for integral parameters of tabular and software methods of metamorphopsia assessment. Dotted line is the mean value of the differences of the integral parameters of metamorphopsia determined by the compared methods. Solid lines are the upper and lower limits of the 95% confidence interval of the differences

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