Metamorphopsia characteristics, causes and treatment

2347
Abraham McLaughlin

The metamorphopsia it is a visual distortion that alters the perception of objects in the visual field. This condition is caused by an alteration in the macula due to a relative displacement of the macular photoreceptors.

The individual with metamorphopsia perceives the size and shape of irregularly shaped objects. Usually, the perception caused by this alteration is characterized by the visualization of straight lines in curved or wavy shapes..

This visual condition affects both animated and inanimate objects, so the subject with metamorphopsia perceives all lines irregularly..

Metamorphopsia is therefore a serious disorder, which notably alters the visual perception of all the elements. For its treatment, it is essential to detect the cause of the macular inflammation that causes the alteration, which can vary in each case.

Article index

  • 1 Features
  • 2 Causes
    • 2.1 Age-related macular degeneration
    • 2.2 Diabetic macular edema
    • 2.3 Obstruction of retinal blood vessels
    • 2.4 Epiretinal membrane
    • 2.5 Vitreoretinal traction
    • 2.6 Uveitis
    • 2.7 Central serous choriodopathy
    • 2.8 Tumors in the macular area
    • 2.9 Macular dystrophies
    • 2.10 Trauma
    • 2.11 Post-operative cataract
    • 2.12 High myopia
    • 2.13 Other non-ocular causes
  • 3 Treatment
  • 4 References

Characteristics

Metamorphopsia is an alteration that causes image distortion. Specifically, it is a condition that causes straight lines to be perceived as wavy; it can also cause a distortion in the perception of the shape and size of objects.

On the other hand, it is important to bear in mind that this alteration is not limited to the perception of specific objects. Metamorphopsia alters the perception of all kinds of objects, as well as the silhouettes and appearance of the people themselves.

Thus, this condition completely alters the visual perception of the person, giving difficulties to estimate the size of visual objects and perceiving straight lines as wavy.

Metamorphopsia is a typical symptom in choroidal disorders, as well as in febrile delusions and epilepsy. In all these cases, the alteration is caused by the relative displacement of the macular photoreceptors.

Causes

Metamorphopsia is a very common symptom of diseases of the center of the retina. The alteration can affect both one eye and both.

In the first case, it is often common for the person to take time to realize that their vision is distorted, since the brain tends to correct the distortion through the vision of the healthy eye.

When both eyes are affected, we speak of bilateral metamorphopsia and the distortion usually appears first in one eye and then in the other. In these cases, individuals may also be slow to realize.

Despite the fact that all cases of metamorphopsia are caused by the relative displacement of the macular photoreceptors, the causes and pathologies that can originate it are very varied and may be different in each case..

In this sense, the pathologies that have shown a greater relationship with metamorphopsia are the following.

Age-related macular degeneration

Macular degeneration is the main disease that leads to the appearance of a distortion of visual perception. It is a pathology that produces a decrease in vision by affecting the central area of ​​the retina.

This alteration is especially prevalent among the elderly population, since it is a disease that in many cases appears with the aging of the ocular regions..

Diabetic macular edema

Some degrees of diabetic retinopathy can cause inflammation of the central area of ​​the retina and lead to macular edema..

Although this type of inflammation does not cause metamorphopsia in all cases, it usually causes this type of alteration.

Retinal blood vessel obstruction

Some types of retinal infarction can damage the center of the retina, inflame its central area, and cause metamorphopsia..

Epiretinal membrane

The epiretinal membrane is a condition that causes vertical and tangential traction of the retina. This alteration can cause an edema of the macula and cause metamorphopsia..

Vitreoretinal traction

Vitreoretinal traction causes a separation of the vitreous and the retina, a fact that can cause vertical traction and cause retinal edema that leads to vision with metamorphopsia.

Uveitis

Uveitis is an inflammatory condition of the posterior pole of the eye. Although it is not common, in some cases it can cause retinal edema and metamorphopsia.

Central serous choriodopathy

This pathology causes the accumulation of fluid under the retina, that is, the back of the inner eye that sends vision information to the brain.

Fluid leaks from the layer of blood vessels under the retina and can cause metamorphopsia..

Tumors in the macular area

Not all tumors located in the macular area cause metamorphopsia. However, depending on the alteration that they originate in the functioning of the eye, it can cause this manifestation.

Macular dystrophies

Macular dystrophies comprise a group of progressive retinal degenerations that affect the macular area. Over time, these pathologies can end up causing metamorphopsia.

Trauma

Blunt eye trauma can sometimes inflame the macula, thus causing metamorphopsia..

Cataract post-operative

Metamorphopsia is a very rare alteration in cataract operations. However, some complicated surgical procedures can lead to cystic macular edema and cause perceptual distortion..

High myopia

High myopia can cause, in some cases, ruptures of the choroid. In these cases, the macula usually suffers a notable inflammation that can end up causing metamorphopsia..

Other non-ocular causes

Finally, non-ocular conditions can also indirectly alter the functioning of the macula and cause metamorphopsia. The most prevalent are migraine and epilepsy.

Treatment

Metamorphopsia is a symptom, not a pathology, so its treatment depends on the underlying disease. In most cases, neurological treatment or drug treatment should be applied, while in some cases surgical intervention is necessary..

When metamorphopsia is caused by some process of degeneration of the retina, it is usually irreversible.

References

  1. García Sánchez J, García Feijoo, J; Ophthalmology Emergencies; Treaty of Medical Emergencies, 2000, Aran Ediciones S.A, 1745-1776.
  2. Kans, JL. Clinical ophthalmology, Barcelona, ​​Doyma SA editions. 1995.
  3. Konidaris V, Androudi S, Brazitikos P. Myopic traction maculopathy: study with spectral domain optical coherence tomography and review of the literature. Hippokratia. 2009; 13: 110-3.
  4. Sun CB, Liu Z, Xue AQ, Yao K. Natural evolution from macular retinoschisis to full-thickness macular hole in highly myopic eyes. Eye (Lond). 2010; 24: 1787-91.
  5. Tosti G. Serous macular detachment and tilted disc syndrome. Ophthalmology. 1999; 106: 1453-5.

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