metamorphopsie

Metamorphopsie, or metamorphopsia in English, is a perceptual disturbance in which straight lines appear curved or bent and objects seem distorted or displaced. It is a symptom rather than a disease, usually reflecting changes in the macula, the central retina responsible for high-acuity vision.

Causes of metamorphopsie are predominantly retinal. Common conditions include age-related macular degeneration, diabetic macular edema or retinal vein occlusion, epiretinal membrane (macular pucker), and macular holes. Central serous chorioretinopathy and other maculopathies can also produce metamorphopsia. Less frequently, distortion may arise from optic nerve disease or after retinal detachment repair. Certain medications or transient inflammatory processes can contribute in rare cases.

Diagnosis typically begins with patient history and a dilated eye examination. The Amsler grid is a simple self-monitoring tool to detect distortion. Imaging tests such as optical coherence tomography (OCT) visualize macular structure, while fundus photography, fluorescein angiography, or OCT angiography assess retinal blood flow and pathology. Microperimetry may map functional sensitivity across the macula.

Treatment targets the underlying condition as there is no specific cure for metamorphopsia itself. Management may include anti-VEGF injections for neovascular AMD or diabetic macular edema, laser therapy, or surgical procedures such as epiretinal membrane peeling or macular hole repair. Prognosis depends on the underlying disease and the extent of structural damage; in many cases distortion improves after treatment, though some degree of metamorphopsia can persist if retinal tissue remains altered.