Effect of vitrectomy for epiretinal membrane on visual function and vision-related quality of life

Am J Ophthalmol. 2009 May;147(5):869-74, 874.e1. doi: 10.1016/j.ajo.2008.11.018. Epub 2009 Feb 6.


Purpose: To evaluate the vision-related quality of life (VR-QOL) in patients undergoing vitrectomy for epiretinal membrane (ERM) removal and to investigate the relationship between VR-QOL and the severity of pre/postoperative metamorphopsia.

Design: Prospective, interventional, consecutive, comparative case series.

Methods: The 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was self-administered by 28 patients (age, 66.7 +/- 8.5 years, mean +/- standard deviation) with ERM before and 3 months after vitrectomy. Preoperative and postoperative clinical data were collected, including logarithm of the minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA), letter contrast sensitivity, central macular thickness, and severity of metamorphopsia. The NEI VFQ-25 was also measured in 26 age-matched normal controls.

Results: The preoperative NEI VFQ-25 composite score was significantly lower in ERM patients than in normal controls (P < .0001). Vitrectomy significantly improved NEI VFQ-25 composite score as well as scores of 10 out of 12 subscales (P < .0001), except for general health and peripheral vision. The postoperative NEI VFQ-25 composite score in ERM patients, however, remained significantly lower than that in normal controls (P < .0001). The preoperative NEI VFQ-25 composite score significantly correlated with the severity of preoperative metamorphopsia (P < .05) but not with preoperative logMAR BCVA, letter contrast sensitivity, and central macular thickness. The postoperative NEI VFQ-25 composite score significantly correlated with the degree of postoperative metamorphopsia and logMAR BCVA (P < .05). The changes in NEI VFQ-25 composite score significantly correlated with changes in the severity of metamorphopsia (P < .05), but not with other parameters.

Conclusions: VR-QOL is significantly impaired in patients with ERM, which is remarkably improved by vitrectomy. The severity of metamorphopsia strongly influences VR-QOL in patients with ERM.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Contrast Sensitivity / physiology
  • Epiretinal Membrane / physiopathology
  • Epiretinal Membrane / surgery*
  • Female
  • Humans
  • Male
  • Prospective Studies
  • Quality of Life*
  • Sickness Impact Profile
  • Surveys and Questionnaires
  • Vision Disorders / physiopathology*
  • Visual Acuity / physiology*
  • Vitrectomy*