OBJECTIVE ASSESSMENT OF PHOTORECEPTOR DISPLACEMENT AND METAMORPHOPSIA- A STUDY OF MACULAR HOLES

Background: We have developed a binocular perimetry technique for the quantitative assessment of retinal photoreceptor displacement and meta morphopsia. Objective: To study the direction and amplitude of retinal photoreceptor displacement in eyes with idiopathic macular holes usin g our binocular perimetry technique. Subjects: Five healthy control su bjects and 10 patients with unilateral stage 3 to 4 macular holes in o ne eye and a healthy fellow eye. Method: Kinetic perimetry using red a nd green filter glasses, black binocular fixation targets, red and gre en selective monocular stimuli (Goldmann III-4-e), and fundus image su perimposition of perimetry data. Results: We found no discrepancy betw een the 2 visual fields in any healthy subjects. In patients with a un ilateral macular hole, the central scotoma invariably extended beyond the rim of the hole. In 8 patients, each point on the rim of the scoto ma had a perceptually corresponding location in the visual field of th e fellow eye that was closer to the center of the visual field. In the 2 patients with the longest duration of symptoms (>2 years), no such discrepancy was found. Conclusions: Differential perimetry enables the objective study of retinal photoreceptor displacement and metamorphop sia. We found objective evidence for radial centrifugal photoreceptor displacement in most patients with idiopathic macular holes.