{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:45:12Z","timestamp":1785545112273,"version":"3.56.0"},"reference-count":24,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Perioper Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Quality of vision in patients with idiopathic epiretinal membranes (iERMs) is closely linked to distorted vision (metamorphopsia), which is often underestimated in clinical settings. Current surgical decision-making relies heavily on visual acuity and optical coherence tomography findings, which do not adequately reflect the patient\u2019s functional vision or the severity of metamorphopsia. There is a clinical need for tools that can reliably quantify this symptom to improve patient outcomes and streamline care pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objectives\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study is the first to assess the use of a novel smartphone-based hyperacuity test (SHT) in quantifying metamorphopsia before and after surgical intervention for iERMs, comparing it with a conventional printed chart.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational study included 27 patients with iERMs with symptomatic metamorphopsia detected on the Amsler grid scheduled for vitrectomy with membrane peeling. The SHT (Alleye, Oculocare Medical Inc) and the horizontal (MH) and vertical (MV) M-chart (Inami &amp; Co, Ltd) tests were performed 3 times before and 3 months after surgery. Pre- and postoperative metamorphopsia scores, changes in distance-corrected visual acuity, optical coherence tomography biomarkers, and subjective perception of metamorphopsia were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean SHT score significantly (\n                      <jats:italic>r<\/jats:italic>\n                      =0.686;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001) improved from 55.2 (SD 18.9) before surgery to 63.5 (SD 16.3) after surgery while the improvement of the M-chart scores were insignificant (MH\n                      <jats:italic>r<\/jats:italic>\n                      =0.37,\n                      <jats:italic>P<\/jats:italic>\n                      =.06; MV\n                      <jats:italic>r<\/jats:italic>\n                      =0.18,\n                      <jats:italic>P<\/jats:italic>\n                      =.36). Pre- and postoperative SHT scores showed very weak and insignificant correlations with the MH, MV, and MH+MV scores. Both metamorphopsia tests showed good reliability (intraclass correlation coefficients &gt;0.75).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SHT showed a significant improvement in postoperative metamorphopsia scores, indicating that it could be a valuable tool for quantifying visual distortion in patients with iERMs. While discrepancies with M-chart results were observed, both tests demonstrated good reliability. Clinically, the SHT may offer a practical solution for monitoring metamorphopsia and guiding complex surgical decision-making, particularly in telemedicine settings. Its accessibility could improve patient management, potentially enhancing preoperative triaging and reducing unnecessary visits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/60959","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T06:45:06Z","timestamp":1741329906000},"page":"e60959-e60959","source":"Crossref","is-referenced-by-count":0,"title":["Quantification of Metamorphopsia Using a Smartphone-Based Hyperacuity Test in Patients With Idiopathic Epiretinal Membranes: Prospective Observational Study"],"prefix":"10.2196","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1212-8173","authenticated-orcid":false,"given":"Daria","family":"Amon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4678-3429","authenticated-orcid":false,"given":"Christoph","family":"Leisser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2157-2203","authenticated-orcid":false,"given":"Andreas","family":"Schlatter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2517-0375","authenticated-orcid":false,"given":"Manuel","family":"Ruiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7372-2927","authenticated-orcid":false,"given":"Caroline","family":"Pilwachs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4907-9982","authenticated-orcid":false,"given":"Natascha","family":"Bayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5238-8295","authenticated-orcid":false,"given":"Josef","family":"Huemer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1393-1598","authenticated-orcid":false,"given":"Oliver","family":"Findl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/7931654","article-title":"Changes in metamorphopsia, visual acuity, and central macular thickness after epiretinal membrane surgery in four preoperative stages classified with OCT B-scan images","volume":"2019","author":"Mao","journal-title":"J Ophthalmol"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0000000000001906","article-title":"To peel or not to peel the internal limiting membrane in idiopathic epiretinal membranes","volume":"38 Suppl 1","author":"D\u00edaz-Valverde","journal-title":"Retina (Philadelphia, Pa)"},{"issue":"7","key":"R3","doi-asserted-by":"publisher","first-page":"3592","DOI":"10.1167\/iovs.12-9493","article-title":"Time course of changes in metamorphopsia, visual acuity, and OCT parameters after successful epiretinal membrane surgery","volume":"53","author":"Kinoshita","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"10","key":"R4","doi-asserted-by":"publisher","first-page":"1584","DOI":"10.1038\/s41433-019-0455-6","article-title":"Reliability and diagnostic performance of a novel mobile app for hyperacuity self-monitoring in patients with age-related macular degeneration","volume":"33","author":"Schmid","journal-title":"Eye (Lond)"},{"issue":"3","key":"R5","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s40123-019-0203-9","article-title":"Odysight: a mobile medical application designed for remote monitoring-a prospective study comparison with standard clinical eye tests","volume":"8","author":"Brucker","journal-title":"Ophthalmol Ther"},{"issue":"11","key":"R6","doi-asserted-by":"publisher","first-page":"3035","DOI":"10.1038\/s41433-020-01356-2","article-title":"False alarms and the positive predictive value of smartphone-based hyperacuity home monitoring for the progression of macular disease: a prospective cohort study","volume":"35","author":"Faes","journal-title":"Eye (Lond)"},{"key":"R7","unstructured":"Portugal T . Figure 3: normal fundus autofluorescence: uniform grayish signal in the fundus and a marked dark appearance in the optic nerve (absence of RPE) and retinal vessels (absorption of fluorescence by hemoglobin and other blood contents). URL: https:\/\/amdbook.org\/content\/figure-3-normal-fundus-autofluorescence-uniform-grayish-signal-fundus-and-marked-dark-appear [Accessed 04-06-2023]"},{"issue":"2","key":"R8","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A guideline of selecting and reporting intraclass correlation coefficients for reliability research","volume":"15","author":"Koo","journal-title":"J Chiropr Med"},{"issue":"436","key":"R9","doi-asserted-by":"publisher","first-page":"1750","DOI":"10.2307\/2291607","article-title":"Straightforward statistics for the behavioral sciences","volume":"91","author":"Wuensch","journal-title":"J Am Stat Assoc"},{"issue":"6","key":"R10","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1007\/s00417-015-3147-3","article-title":"Two-year results of metamorphopsia, visual acuity, and optical coherence tomographic parameters after epiretinal membrane surgery","volume":"254","author":"Kinoshita","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"issue":"19\u201328","key":"R11","doi-asserted-by":"publisher","first-page":"19","DOI":"10.2174\/1874364101812010019","article-title":"Accuracy of a self-monitoring test for identification and monitoring of age-related macular degeneration: a diagnostic case-control study","volume":"12","author":"Schmid","journal-title":"Open Ophthalmol J"},{"issue":"4","key":"R12","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1038\/s41433-022-01959-x","article-title":"System usability, user satisfaction and long-term adherence to mobile hyperacuity home monitoring-prospective follow-up study","volume":"37","author":"Faes","journal-title":"EYE (Lond)"},{"issue":"12","key":"R13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-056940","article-title":"Visual outcomes and treatment adherence of patients with macular pathology using a mobile hyperacuity home-monitoring app: a matched-pair analysis","volume":"11","author":"Gross","journal-title":"BMJ Open"},{"issue":"8","key":"R14","doi-asserted-by":"publisher","first-page":"2961","DOI":"10.1167\/iovs.04-1104","article-title":"Retinal contraction and metamorphopsia scores in eyes with idiopathic epiretinal membrane","volume":"46","author":"Arimura","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R15","volume":"64","author":"Kuroyanagi","journal-title":"Jpn J Clin Ophthalmol"},{"issue":"9","key":"R16","doi-asserted-by":"publisher","first-page":"4012","DOI":"10.1167\/iovs.03-0117","article-title":"Quantification of metamorphopsia in patients with epiretinal membranes","volume":"44","author":"Matsumoto","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"10","key":"R17","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1055\/a-1756-5243","article-title":"Diagnostic reliability of optical coherence tomography biomarkers for postsurgical success in visual acuity in patients with idiopathic epiretinal membranes","volume":"240","author":"Leisser","journal-title":"Klin Monbl Augenheilkd"},{"issue":"2","key":"R18","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1097\/IAE.0000000000003646","article-title":"New artificial intelligence analysis for prediction of long-term visual improvement after epiretinal membrane surgery","volume":"43","author":"Crincoli","journal-title":"Retina (Philadelphia, Pa)"},{"issue":"1","key":"R19","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2415-13-13","article-title":"M-charts as a tool for quantifying metamorphopsia in age-related macular degeneration treated with the bevacizumab injections","volume":"13","author":"Nowomiejska","journal-title":"BMC Ophthalmol"},{"issue":"5","key":"R20","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1111\/ceo.13097","article-title":"Gaming to improve vision: 21st century self\u2010monitoring for patients with age\u2010related macular degeneration","volume":"46","author":"Razavi","journal-title":"Clin Exp Ophthalmol"},{"issue":"9","key":"R21","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1097\/IAE.0b013e3182899258","article-title":"Feasibility of a novel remote daily monitoring system for age-related macular degeneration using mobile handheld devices: results of a pilot study","volume":"33","author":"Kaiser","journal-title":"Retina (Philadelphia, Pa)"},{"key":"R22","unstructured":"NHS digital. Online access to GP health records. Mar5, 2025. URL: https:\/\/digital.nhs.uk\/services\/nhs-app\/nhs-app-guidance-for-gp-practices\/guidance-on-nhs-app-features\/online-access-to-gp-health-records [Accessed 12-06-2023]"},{"key":"R23","unstructured":"Alleye. Alleye becomes a digital companion for patients with retinal disease. Medium; 2023. URL: https:\/\/medium.com\/@technology_11408\/alleye-becomes-a-digital-companion-for-patients-with-a-retinal-disease-f98e234929c5 [Accessed 12-06-2023]"},{"issue":"10","key":"R24","doi-asserted-by":"publisher","first-page":"2759","DOI":"10.1007\/s40123-024-01020-y","article-title":"Digital exclusion, social deprivation, and clinical outcomes of patients undergoing hyperacuity home monitoring","volume":"13","author":"Mendall","journal-title":"Ophthalmol Ther"}],"container-title":["JMIR Perioperative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/periop.jmir.org\/2025\/1\/e60959","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:31:34Z","timestamp":1785537094000},"score":1,"resource":{"primary":{"URL":"https:\/\/periop.jmir.org\/2025\/1\/e60959"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,17]]},"references-count":24,"URL":"https:\/\/doi.org\/10.2196\/60959","relation":{},"ISSN":["2561-9128"],"issn-type":[{"value":"2561-9128","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,17]]},"article-number":"v8i7e60959"}}