Distortion

Introduction The deformation of the object is caused by the lesion of the retina or the macula, which causes the image of the object to be distorted and changed. Age-related macular degeneration is divided into dry and wet types. It is related to long-term photodamage, genetics, metabolism, nutrition and other factors of the macula. Some macular lesions or retinal and choroidal lesions near the macula, due to obvious edema of the retina, make the interval of visual cells on the retina widen, or due to retinal adhesions, scar contraction traction, so that the visual cells are crowded or overlapped, etc. When things are, the shape and size of the object will change greatly, such as the object becomes smaller or the object becomes larger.

Cause

Some macular lesions or retinal and choroidal lesions near the macula, due to obvious edema of the retina, make the interval of visual cells on the retina widen, or due to retinal adhesions, scar contraction traction, so that the visual cells are crowded or overlapped, etc. When things are, the shape and size of the object will change greatly, such as the object becomes smaller or the object becomes larger.

an examination

Related inspection

Fundus examination, fundus examination, optic nerve hole

The patient can be diagnosed with subjective symptoms. The concave light reflection disappeared in the fundus examination center, and the retinal reflection enhancement of the macula was glassy. Sometimes it is difficult to judge under the ophthalmoscope. Under the three-sided mirror, occasionally the retina showed a cystic change. FFA can be diagnosed. Can also be seen in RVO, chronic CME, intraocular inflammation, retinitis pigmentosa and other fundus diseases, ocular trauma and photocoagulation, after condensation. The contraction of the membrane can cause wrinkles, deformation, and macular edema of the macula, causing vision loss and visual distortion. When the ERM is thick and obscures the fovea, and the visual acuity is significantly reduced or deformed, the vitreous surgery can be used to remove the anterior membrane.

Differential diagnosis

Differential diagnosis of visual distortion:

First, the central serous chorioretinopathy: more common in men aged 20 to 45, usually manifested as self-limiting disease. It is characterized by a shadow in front of the eye, deformation of the object, such as getting smaller and farther; the vision is reduced, but often not less than 0.5, and can be partially corrected by the convex lens. There is a round reflective wheel on the fundus, the central concave dark red, the light reflection disappears, there may be gray-white subretinal fibrin deposition, under the binocular indirect ophthalmoscope, the macula is a dome-shaped disc-shaped detachment zone. Fluorescence angiography, in the venous phase, has one or several fluorescein leakage points in the macula, gradually ejecting or ink-like, and expanding into strong fluorescent spots.

Second, age-related macular degeneration: is a common blind eye disease in developed areas over 50 years old. As society ages, the incidence increases. Divided into dry and wet. May be related to long-term chronic photodamage, genetics, metabolism, nutrition and other factors.

Third, cystoid macular edema: not an independent disease, often caused by other diseases. The pathological feature is that intraretinal edema contains a honeycomb-like cyst. FFA showed that the edema came from retinal capillaries with abnormal permeability around the fovea, showing most small leaks, and the accumulation of fluorescence in the cyst, which formed a petal shape due to the radial arrangement of the Henle fibers. It is characterized by decreased vision or visual distortion, or the symptoms are not obvious. The concave light reflection disappeared in the fundus examination center, and the retinal reflection enhancement of the macula was glassy. Sometimes it is difficult to judge under the ophthalmoscope. Under the three-sided mirror, occasionally the retina showed a cystic change. FFA can be diagnosed.

Fourth, macular and pigment epithelial dystrophy: mainly manifested as yellow spots and RPE yellow substance deposition, and the gradual loss of cells.

Five, macular hole: can be caused by trauma, degeneration, long-term CME, high myopia, vitreous traction. The fundus appears as a dark red hole with a clear boundary with a 1/2 to 1/4 PD size and a yellow particle at the bottom of the hole. The central vision decreased significantly. The macular hole in high myopia has a great chance of retinal detachment, requiring retinal detachment surgery or vitreous surgery.

6. The macular epiretinal membrane: occurs on the inner surface of the retina, which is a fibrotic membrane formed by the migration and proliferation of retinal glial cells and RPE. Can occur in a variety of lesions. The macular ERM formed after retinal detachment is thicker and grayish white, affecting vision. Can also be seen in RVO, chronic CME, intraocular inflammation, retinitis pigmentosa and other fundus diseases, ocular trauma and photocoagulation, after condensation. The contraction of the membrane can cause wrinkles, deformation, and macular edema of the macula, causing vision loss and visual distortion. When the ERM is thick and obscures the fovea, and the visual acuity is significantly reduced or deformed, the vitreous surgery can be used to remove the anterior membrane.

The patient can be diagnosed with subjective symptoms.

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