, central scotoma, or impaired color vision may also occur.
Anatomical changes of the fovea induced by VMT can lead to typical symptoms of reduced visual acuity, decreased reading vision, metamorphopsia, and micropsia
. The natural history of patients with VMT is not well established, but it is thought that 11%-40% of symptomatic VMT dissolve spontaneously in 8-12 months, although restoration of foveal anatomy is uncertain (2).
Symptoms included decreased visual acuity (VA) and color vision, micropsia
, metamorphopsia, or paracentral scotoma.
In these cases, the sensory impairment (Syndrome of Alice in Wonderland) is an episodic syndrome characterized by a smaller (micropsia
) or greater (macropsia) perception disorder of the patient's own body or surroundings.
Amsler grid test elucidated metamorphopsia in 70% of patients, which was more pronounced in just outside non-seeing area, positive scotoma in 78% and micropsia
in 4% of patients.
The patient had suffered, to variable degrees, from painless blurred vision, dyschromatopsia, and micropsia
for more than 2 years.
In order to collect data for pathophysiological sections, we consulted PubMed indexed articles using "macropsia", "micropsia
", "macrosomatognosia", "microsomatognosia", etc., even if the term Alice in Wonderland Syndrome was not expressly used.
Table 1: Change in symptoms with Clonazepam DSM IV/V Symptom Prior to 3 months after Checklist treatment with initiation of Clonazepam Clonazepam treatment Geometric Present Absent hallucinations False perception of Present Absent movement in peripheral fields Flashes of colour Present Absent Intensified colours Present Absent Trails of images of Present Absent moving objects Positive after Present Absent images Halos around Present Present but reduced objects in intensity and frequency Macropsia Present Absent Micropsia
Objects can be described as distorted and eventually changed in size (macropsia or micropsia
), shape (metamorphopsia), illumination, colour, or clarity.
There are no symptoms in the early stages of ARMD, but as far as the lesions are extended patients suffer from progressive visual loss, difficulty in reading and object recognition, central or paracentral scotomas, micropsia
, and metamorphopsia .