Macular assessment of preoperative optical coherence tomography in ageing Chinese undergoing routine cataract surgery

Abstract

This retrospective consecutive case series aimed to evaluate spectral-domain optical coherence tomography (SD-OCT) for occult macular disease recognition preoperatively in patients scheduled for routine cataract surgery. All patients scheduled for cataract surgery underwent macular SD-OCT. Scans were reviewed for retinal, retinal pigment epithelium and vitreomacular interface abnormalities. For the subgroup analysis, the following information was collected: age; sex; and diabetes, hypertension, myopia, glaucoma, post intra-ocular surgery, endophotocoagulation, retinal vasculopathy and uveitis statuses. One-thousand-one-hundred-seventy-six consecutive scans were acquired from 1,176 patients. Macular pathology was found in 294 eyes. The most common macular disorders were an epiretinal membrane (n = 130), myopia atrophy (n = 61) and a dome-shaped macular with pathologic myopia (n = 32). One-hundred-thirty eyes (11.05%) presented macular epiretinal membranes not detected by dilated fundus examination, accounting for 44.22% of the abnormalities in diseased eyes and was higher than in previous Chinese studies. Some had multiple macular disorders. The most common ocular history was myopia, including high myopia. The pooled prevalence rate of macular diseases detected by OCT was 0.24 (95% CI 0.14–0.34) using meta-analysis. SD-OCT should be performed for routine cataract surgery patients to evaluate visual outcomes, especially in myopic patients and those considering advanced-technology intraocular lenses.

Prevalence of Macular Abnormalities Identified Only on Optical Coherence Tomography in Korean Patients Scheduled for Cataract Surgery

“…Furthermore, the most common macular abnormality identified in this study was age-related macular degeneration accounting for 2.4% of patients (2.1% of eyes), followed by epiretinal membrane accounting for 2.3% of patients (2.0% of eyes) included in this study. Previous studies corroborate our findings, indicating age-related macular degeneration (3.2%) in of Zafar et al [ 7 ]’s study and epiretinal membrane (3.3% and 11.05% respectively) in Pinto et al [ 5 ] and Huang et al [ 6 ]’s studies as the most common macular abnormality. Moreover, among the 35 patients with an abnormal OCT finding, both eyes in 18 patients were included in this study, and 11 patients (61.1%) also had macular abnormalities in the fellow eye.…”

Swept-Source Optical Coherence Tomography Biometer as Screening Strategy for Macular Disease in Patients Scheduled for Cataract Surgery

“…In the past few decades, significant advances in phacoemulsification with IOL implantation have led to improved refractive outcomes and higher patient satisfaction. However, macular changes sheltered by cataract 6 can reduce surgical success as well as patient and ophthalmologist expectation 7 . Therefore, preoperative assessment is crucial to identify patients with unknown macular disease that may affect final visual outcomes.…”

An Optical Coherence Tomography-Based Deep Learning Algorithm for Visual Acuity Prediction of Highly Myopic Eyes After Cataract Surgery

“…With the wide application of optical coherence tomography (OCT), surgeons could assess the fundus status of highly myopic eyes on an anatomical scale ( Huang et al, 2018 ; Li et al, 2018 ), but the morphological diagnoses were hard to be directly associated with the actual manifested visual acuity (VA). Therefore, difficulties might occur when surgeons want to predict the postoperative VA and explain the prognosis to the highly myopic patients during preoperative conversations, which might thereby affect the overall surgical planning and patients’ satisfaction with the surgery later.…”