prevalence and predictors of metamorphopsia after successful vitrectomy surgery for macula-off rhegmatogenous retinal detachment


Hsouna Zgolli
Chiraz Abdelhedi
Racem Choura
Mouna Abdaoui
Olfa Fekih
Leila Nacef


Aim: To estimate metamorphopsia prevalence, predictors and etiologies in patients operated for rhegmatogenous retinal detachment (RRD)
with detached macula with successful results.
Methods: Retrospective study including 50 eyes of 50 patients who underwent pars plana vitrectomy for RRD with detached macula with standard silicone oil (SO) tamponade. Patients who had successful surgery with durable anatomic reapplication of the retina after SO removal were
included. Patients were examined on day 1, day 7,1 month, and 3 months after surgery. Best corrected visual acuity, Amsler grid, fundus biomicroscopy, Spectral Domain Optical Coherence Tomography (SD-OCT) and fundus auto-fluorescence (FAF) were performed in all patients
after surgery. Structural abnormalities such as macular folds, macular epiretinal membrane, cystoid macular edema, and foveal disruption of
the ellipsoid layer were observed on SD-OCT. Macular displacement was identified on FAF.
Results: We identified metamorphopsia as post-operative visual impairment in 27 patients among 50 (54%). Clinical assessment found that a
delay > 7 days between symptoms and surgery (p<0.001), more than 2 detached quadrants (p=0.012), and stage C of proliferative vitreoretinopathy (p=0.035) were associated to metamorphopsia. Regarding multimodal imaging findings, only macular folds and macular displacement
were significantly correlated with the occurrence of postoperative metamorphopsia (p<0.001).
Conclusion: Metamorphopsia is a common complaint after vitrectomy for RRD. Macular rotation and folds would be the main causes after
complete and durable reapplication of the retina.


Rhegmatogenous retinal detachment, Metamorphopsia, Vitrectomy, Multimodal imaging.



  1. Kumar V, Naik A, Kumawat D, et al. Multimodal imaging of eyes with metamorphopsia after vitrectomy for rhegmatogenous retinal detachment. Indian J Ophthalmol 2021;69(10):2757‑65.
  2. Schawkat M, Valmaggia C, Lang C, Scholl HP, Guber J. Multimodal imaging for detecting metamorphopsia after successful retinal detachment repair. Graefes Arch Clin Exp Ophthalmol 2020;258(1):57‑61.
  3. Okuda T, Higashide T, Sugiyama K. Metamorphopsia and outer retinal morphologic changes after successful vitrectomy surgery for macula-off rhegmatogenous retinal detachment. Retina Phila Pa 2018;38(1):148‑54.
  4. Okamoto F, Sugiura Y, Okamoto Y, Hiraoka T, Oshika T. Metamorphopsia and Optical Coherence Tomography Findings After Rhegmatogenous Retinal Detachment Surgery. Am J Ophthalmol 2014;157(1):214-220.e1.
  5. Van de Put MAJ, Vehof J, Hooymans JMM, Los LI. Postoperative metamorphopsia in macula-off rhegmatogenous retinal detachment: associations with visual function, vision related quality of life, and optical coherence tomography findings. PloS One 2015;10(4):e0120543.
  6. Lee E, Williamson TH, Hysi P, et al. Macular displacement following rhegmatogenous retinal detachment repair. Br J Ophthalmol 2013;97(10):1297‑302.
  7. Rossetti A, Doro D, Manfrè A, Midena E. Long-term follow-up with optical coherence tomography and microperimetry in eyes with metamorphopsia after macula-off retinal detachment repair. Eye Lond Engl 2010;24(12):1808‑13.
  8. Fu Y, Zhang YL, Gu ZH, Zhang HJ, Wang LY, Geng RF. Analysis of factors of metamorphopsia after vitrectomy for rhegmatogenous retinal detachment. Int Eye Sci 2021;21:906‑9.
  9. Fukuyama H, Ishikawa H, Komuku Y, Araki T, Kimura N, Gomi F. Comparative analysis of metamorphopsia and aniseikonia after vitrectomy for epiretinal membrane, macular hole, or rhegmatogenous retinal detachment. PloS One 2020;15(5):e0232758.
  10. Zhou C, Lin Q, Chen F. Prevalence and predictors of metamorphopsia after successful rhegmatogenous retinal detachment surgery: a cross-sectional, comparative study. Br J Ophthalmol 2017;101(6):725‑9.
  11. Codenotti M, Fogliato G, Iuliano L, et al. Influence of intraocular tamponade on unintentional retinal displacement after vitrectomy for rhegmatogenous retinal detachment. Retina Phila Pa 2013;33(2):349‑55.