Application of macular spectral domain OCT as a screening tool prior to cataract surgery

Session Details

Session Title: Cataract Surgery & Retinal Complications

Session Date/Time: Tuesday 25/09/2018 | 16:30-18:00

Paper Time: 17:40

Venue: Room A3, Podium 1

First Author: : H.Kapania INDIA

Co Author(s): :    R. Shetty   C. Jayadev   M. Kurian              

Abstract Details

Purpose:

To employ spectral-domain optical coherence tomography (SD-OCT) to identify macular pathologies preoperatively in patients undergoing cataract surgery with intraocular lens (IOL) implantation. It aimed at detecting pathologies that could be missed clinically and to further evaluate clinically obvious pathologies. This could help us predict the visual prognosis of cataract patients after surgery and even alter the treatment plan for some macular pathologies.

Setting:

Narayana Nethralaya hospital, Bangaluru, India

Methods:

A prospective longitudinal study was performed for a case series of two thousand eight hundred and eighty-four (2884) eyes having immature senile cataract scheduled for cataract surgery. All the patients underwent pre-operative vision, refraction and anterior and posterior segment examination. Following this, the eyes were subjected to macular SD-OCT. The scans were analyzed to rule out pathologies of the retinal pigment epithelium, retinal layers, and vitreomacular interface. After cataract surgery, post-operative (1 month) vision and refraction were recorded. For subgroup analysis, the following particulars were collected: age, gender, eye to be operated and systemic illness.

Results:

Scans were obtained for 2884 eyes.Macular pathology was found in 562 eyes (19.5 %) after OCT compared to 482 eyes (16.7%) detected clinically. Media opacities precluded interpretation of 297 scans (10%). The most common condition detected was age-related macular degeneration in 288 eyes (10%) followed by the epiretinal membrane in 201 eyes (7%). 112 eyes (3.9%) had the epiretinal membrane with foveal contour alterations. Vitreomacular traction was found in 43 eyes (1.5%). There were 4 eyes (0.14%) with cystoid macular edema and 3 eyes (0.10%) with the full-thickness macular hole for which treatment plan was altered after OCT analysis.

Conclusions:

An additional 2.8 % eyes had clinically undetectable macular pathology that was detected on macular OCT. Thus, SD-OCT scanning was effective in identifying those macular pathologies which could not be picked up clinically as well as in objective prognostication for clinically obvious pathologies.

Financial Disclosure:

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