Aniseikonia in various retinal disorders

  • Fumiki OkamotoEmail author
  • Yoshimi Sugiura
  • Yoshifumi Okamoto
  • Takahiro Hiraoka
  • Tetsuro Oshika
Retinal Disorders



The purpose was to quantify and compare the severity of aniseikonia in patients undergoing vitrectomy for various retinal disorders.


We studied 357 patients with retinal disorders including epiretinal membrane (ERM), macular hole (MH), cystoid macular edema with branch / central retinal vein occlusion (BRVO-CME / CRVO-CME), diabetic macular edema (DME), macula-off rhegmatogenous retinal detachment (M-off RD), and macula-on RD (M-on RD) as well as 31 normal controls. The amount of aniseikonia was measured using the New Aniseikonia Test preoperatively and at 6 months postoperatively.


Of all patients, 59% presented aniseikonia. Preoperative and postoperative mean aniseikonia were 4.0 ± 4.1% and 3.0 ± 3.6%, respectively. In particular, 68% of patients with ERM had macropsia, and approximately half of MH, RVO-CME, DME, and M-off RD patients had micropsia. Preoperative aniseikonia was significantly severe in ERM than in other disorders. Vitrectomy improved aniseikonia only in MH, while visual acuity was improved in all disorders except CRVO-CME.


More than half of the patients showed aniseikonia preoperatively. A majority of ERM patients exhibited macropsia, whereas MH, RVO-CME, DME, and macula-off RD patients presented micropsia. The aniseikonia score was greatest in ERM patients. In most retinal disorders, surgery significantly improved visual acuity, but not aniseikonia.


Aniseikonia Micropsia Macropsia Vitrectomy Retinal disorders 


Compliance with ethical standards


No funding was received for this research.

Conflict of Interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Berens C, Aniseikonia BRE (1963) A present appraisal and some practical considerations. Arch Ophthalmol 70:181–188CrossRefPubMedGoogle Scholar
  2. 2.
    Kramer PW, Lubkin V, Pavlica M, Covin R (1999) Symptomatic aniseikonia in unilateral and bilateral pseudophakia. A projection space eikonometer study. Binocul Vis Strabismus Q 14:183–190PubMedGoogle Scholar
  3. 3.
    Katsumi O, Miyanaga Y, Hirose T et al (1988) Binocular function in unilateral aphakia. Correlation with aniseikonia and stereoacuity. Ophthalmology 95:1088–1093CrossRefPubMedGoogle Scholar
  4. 4.
    Crone RA, Leuridan OM (1975) Unilateral aphakia and tolerance of aniseikonia. Ophthalmologica 171:258–263CrossRefPubMedGoogle Scholar
  5. 5.
    Snead MP, Lea SH, Rubinstein MP et al (1991) Aniseikonia: a method of objective assessment in pseudophakia using geometric optics. Ophthalmic Physiol Opt 11:109–112CrossRefPubMedGoogle Scholar
  6. 6.
    Häring G, Gronemeyer A, Hedderich J, de Decker W (1999) Stereoacuity and aniseikonia after unilateral and bilateral implantation of the Array refractive multifocal intraocular lens. J Cataract Refract Surg 25:1151–1156CrossRefPubMedGoogle Scholar
  7. 7.
    Katsumi O, Miyajima H, Ogawa T, Hirose T (1992) Aniseikonia and stereoacuity in pseudophakic patients. Unilateral and bilateral cases. Ophthalmology 99:1270–1277CrossRefPubMedGoogle Scholar
  8. 8.
    Gobin L, Rozema JJ, Tassignon MJ (2008) Predicting refractive aniseikonia after cataract surgery in anisometropia. J Cataract Refract Surg 34:1353–1361CrossRefPubMedGoogle Scholar
  9. 9.
    Benegas NM, Egbert J, Engel WK, Kushner BJ (1999) Diplopia secondary to aniseikonia associated with macular disease. Arch Ophthalmol 117:896–899CrossRefPubMedGoogle Scholar
  10. 10.
    de Wit GC, Muraki CS (2006) Field-dependent aniseikonia associated with an epiretinal membrane a case study. Ophthalmology 113:58–62CrossRefPubMedGoogle Scholar
  11. 11.
    Ugarte M, Williamson TH (2005) Aniseikonia associated with epiretinal membranes. Br J Ophthalmol 89:1576–1580CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Okamoto F, Sugiura Y, Okamoto Y et al (2014) Time course of changes in aniseikonia and foveal microstructure after vitrectomy for epiretinal membrane. Ophthalmology 121:2255–2260CrossRefPubMedGoogle Scholar
  13. 13.
    Chung H, Son G, Hwang DJ et al (2015) Relationship Between Vertical and Horizontal Aniseikonia Scores and Vertical and Horizontal OCT Images in Idiopathic Epiretinal Membrane. Invest Ophthalmol Vis Sci 56:6542–6548CrossRefPubMedGoogle Scholar
  14. 14.
    Han J, Han SH, Kim JH, Koh HJ (2016) Restoration of retinally induced aniseikonia in patients with epiretinal membrane after early vitrectomy. Retina 36:311–320CrossRefPubMedGoogle Scholar
  15. 15.
    Rutstein RP (2012) Retinally induced aniseikonia: a case series. Optom Vis Sci 89:e50–55PubMedGoogle Scholar
  16. 16.
    Curtin BJ, Linksz A, Shafer DM (1959) Aniseikonia following retinal detachment. Am J Ophthalmol 47:468–471CrossRefPubMedGoogle Scholar
  17. 17.
    Ugarte M, Williamson TH (2006) Horizontal and vertical micropsia following macula-off rhegmatogenous retinal-detachment surgical repair. Graefes Arch Clin Exp Ophthalmol 244:1545–1548CrossRefPubMedGoogle Scholar
  18. 18.
    Sjöstrand J, Anderson C (1986) Micropsia and metamorphopsia in the re-attached macula following retinal detachment. Acta Ophthalmol (Copenh) 64:425–432CrossRefGoogle Scholar
  19. 19.
    Okamoto F, Sugiura Y, Okamoto Y et al (2014) Aniseikonia and Foveal Microstructure after Retinal Detachment Surgery. Invest Ophthalmol Vis Sci 55:4880–4885CrossRefGoogle Scholar
  20. 20.
    Lee HN, Lin KH, Tsai HY et al (2014) Aniseikonia following pneumatic retinopexy for rhegmatogenous retinal detachment. Am J Ophthalmol 158:1056–1061CrossRefPubMedGoogle Scholar
  21. 21.
    Frisén L, Frisén M (1979) Micropsia and visual acuity in macular edema. A study of the neuro-retinal basis of visual acuity. Albrecht Von Graefes Arch Klin Exp Ophthalmol 210:69–77CrossRefPubMedGoogle Scholar
  22. 22.
    Hisada H, Awaya S (1992) Aniseikonia of central serous chorioretinopathy. Nihon Ganka Gakkai Zasshi 96:369–374PubMedGoogle Scholar
  23. 23.
    de Wit GC (2008) Clinical usefulness of the Aniseikonia Inspector: a review. Binocul Vis Strabismus Q 23:207–214PubMedGoogle Scholar
  24. 24.
    Asaria R, Garnham L, Gregor ZJ, Sloper JJ (2008) A prospective study of binocular visual function before and after successful surgery to remove a unilateral epiretinal membrane. Ophthalmology 115:1930–1937CrossRefPubMedGoogle Scholar
  25. 25.
    Murakami T, Tsujikawa A, Ohta M et al (2007) Photoreceptor status after resolved macular edema in branch retinal vein occlusion treated with tissue plasminogen activator. Am J Ophthalmol 143:171–173CrossRefPubMedGoogle Scholar
  26. 26.
    Lardenoye CW, Probst K, DeLint PJ, Rothova A (2000) Photoreceptor function in eyes with macular edema. Invest Ophthalmol Vis Sci 41:4048–4053PubMedGoogle Scholar
  27. 27.
    Wright LA, Cleary M, Barrie T, Hammer HM (1999) Motility and binocularity outcomes in vitrectomy versus scleral buckling in retinal detachment surgery. Graefes Arch Clin Exp Ophthalmol 237:1028–1032CrossRefPubMedGoogle Scholar
  28. 28.
    Pesin SR, Olk RJ, Grand MG et al (1991) Vitrectomy for premacular fibroplasia: prognostic factors, long-term follow-up, and time course of visual improvement. Ophthalmology 98:1109–1114CrossRefPubMedGoogle Scholar
  29. 29.
    Oshima Y, Yamanishi S, Sawa M et al (2000) Two-year follow-up study comparing primary vitrectomy with scleral buckling for macula-off rhegmatogenous retinal detachment. Jpn J Ophthalmol 44:538–549CrossRefPubMedGoogle Scholar
  30. 30.
    Chang SD, Kim IT (2000) Long-term visual recovery after scleral buckling procedure of rhegmatogenous retinal detachment involving the macula. Korean J Ophthalmol 14:20–26CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Fumiki Okamoto
    • 1
    Email author
  • Yoshimi Sugiura
    • 1
  • Yoshifumi Okamoto
    • 1
  • Takahiro Hiraoka
    • 1
  • Tetsuro Oshika
    • 1
  1. 1.Department of Ophthalmology, Faculty of MedicineUniversity of TsukubaTsukubaJapan

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