Patients with epiretinal membrane (ERM) often have only mild symptoms of visual impairment, but the experience can still affect quality of life, as can the natural compensation methods patients often employ. Closing one eye to improve vision, also known as binocular interference, is one feature common in patients with ERM, a new study suggests.
Researchers conducted a medical record review at an adult strabismus clinic at a tertiary referral center and included 135 patients seen between June 2010 and October 2019. Each patient completed the Adult Strabismus-20 questionnaire, including a question on binocular interference. Those who reported closing one eye sometimes or more comprised one group (n=124), and those who reported no eye closure comprised the control group (n=11).
The researchers examined the frequencies of central-peripheral rivalry (CPR)-type diplopia (also known as dragged fovea diplopia), binocular interference defined as monocular eye closure without diplopia or strabismus, and other presentations associated with monocular eye closure. They then compared visual acuity, metamorphopsia, aniseikonia and the Adult Strabismus-20 quality of life scores between the binocular interference group, a CPR-type diplopia group and the control patients.
The researchers found 29% of patients who closed one eye did so due to binocular interference, while 27% had CPR-type diplopia and 44% did so for other reasons, namely strabismus.
When compared with the control group, those with binocular interference had worse quality of life as reported on the Adult Strabismus-20 questionnaire for reading function and general function domains. Compared with CPR-type diplopia, those with binocular interference had poorer worst-eye visual acuity and a larger interocular difference.
The researchers concluded that binocular interference is a “distinct entity affecting quality of life in patients with epiretinal membrane.” Those with ERM and binocular interference tend to have reduced quality of life as a direct result.
Hatt SR, Leske DA, Iezzi Jr. R, et al. Binocular interference vs. diplopia in patients with epiretinal membrane. JAMA Ophthalmology. Septemebr 10, 2020. [Epub ahead of print].