Intraoperative Optical Coherence Tomography in the Management of Macular Holes: State of the Art and Future Perspectives

Abstract

Background: Non-invasive diagnostic technologies in ophthalmology have substantially transformed contemporary clinical practice. Intraoperative optical coherence tomography (iOCT) systems have recently been used for various surgical interventions, including the treatment of full-thickness macular holes (FTMHs). Materials and Methods: We conducted a systematic review on the use of iOCT and its possible benefits in the management of FTMHs, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). The level of evidence according to the Oxford Centre for Evidence-Based Medicine (OCEM) 2011 guidelines, and the quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, were assessed for all included articles. Results: 1131 articles were initially extracted, out of which 694 articles were obtained after duplicates were removed and their abstracts screened. A total of 65 articles was included for full-text review. Finally, 17 articles remained that fulfilled the inclusion criteria. Conclusions: Even though there is just a small number of studies with solid results, the use of iOCT in FTMH surgery may be a helpful tool for both novice and experienced surgeons planning and managing difficult cases. Additionally, it could be used for teaching reasons and for exploring novel surgical techniques.

Clinical significance of signal shadowing during intraoperative optical coherence tomography-assisted vitreoretinal surgery

“…This small dimension was interpreted by our study group to be clinically irrelevant because the outline of the underlying tissue could still be easily identified 20 . This was also the approach taken by several studies that developed similar analytical interpretations or adopted such benchmarks in their study design 2 , 7 . Yet, this discrepancy prompts the need to establish objective criteria that determine what a clinically relevant interference is, to create a standard unitary interpretation that could ensure analysis reproductivity and enhance the compatibility of future references of the data.…”