Sensitivity of spectral domain optical coherence tomography in the diagnosis of posterior vitreous detachment in vitreomacular interface disorders: A prospective cohort study

Abstract

Purpose: To evaluate the sensitivity of Spectral Domain Optical Coherence Tomography (SD-OCT) regarding the diagnosis of posterior vitreous detachment (PVD) in vitreomacular interface disorders (VID). Methods: A total of 48 eyes of 48 patients were included in this prospective cohort study. PVD in eyes with VID was investigated. We determined the status of posterior vitreous cortex using slit lamp (SL) biomicroscopy and SD-OCT preoperatively, during vitrectomy and on the intraoperative video recording. Sensitivity and specificity of the examining methods were analysed. Four masked independent examiners participated in this study. Results: PVD was diagnosed in 16 eyes (33.3%) on SD-OCT, 20 eyes (41.7%) on SL examination and 28 eyes (58.3%) during vitrectomy. Sensitivity and specificity for diagnosis of PVD was 37.5% and 31.3% using SD-OCT, 90% and 64.3% on the SL examination, 92.9% and 90% on the video recording respectively, compared to the intraoperative PVD diagnosis. Conclusion: SD-OCT shows a relatively low detection sensitivity of PVD in VID. Thorough OCT investigation is necessary to establish an appropriate diagnosis of PVD and treatment in VID.

Comparison of Posterior Hyaloid Assessment Using Preoperative Optical Coherence Tomography and Intraoperative Triamcinolone Acetonide Staining During Vitrectomy

“…The main finding in this study is that preoperative OCT may not be sufficiently sensitive to detect the status of the posterior hyaloid, which seems to imply that intraoperative TA staining is recommendable in most vitreoretinal pathologies. This confirms the findings described previously by Hwang et al 7 and Stavrakas et al 8 The new approach of this study is that we, for the first time, quantified the ability of OCT to diagnose PVD, compared to intraoperative TA-assisted assessment, which allowed us to estimate the sensitivity and specificity of this OCT-based diagnosis, in a range of retinal conditions.…”

“…They also sought to identify minimally invasive imaging modalities that could be used reliably and efficiently in clinical settings for the detection of PVD, reporting that B-scan ultrasound was accurate but, importantly, operator-dependent. Similar observations were published by Muqit et al and Vaz-Pereira et al, 17,18 who evaluated the OCT features of neovascular complexes and correlated the results of an earlier study by Chu et al 19 Gupta et al found that vitreoschisis was present in 53% of patients with MH, as revealed by OCT. 20 Recently, Stavrakas et al 8 reported low sensitivity and specificity (37.5% and 31.3%) of spectral domain OCT in patients undergoing vitrectomy for diagnosis of ERM, MH and VMT. Although several studies have attempted to describe the findings in diabetic patients with ERM on time-domain OCT 21 and more recently on spectral-domain OCT, 22 our description of the intraoperative findings and poor specificity of OCT are consistent with a report by Gandorfer et al, 23 in which 60 of 61 eyes with diabetic macular edema (98.3%) and tangential VMT were examined with electron microscopy and showed native vitreous collagen overlying the macula.…”

Accuracy of biomicroscopy, ultrasonography and spectral-domain OCT in detection of complete posterior vitreous detachment

“…As a part of preoperative preparation, all patients underwent complete systemic evaluation which included general laboratory ndings and a complete systemic examination to identify systemic diseases and drug use. In order to maximize the chance of achieving the appropriate vitreous evaluation, a complete preoperative ophthalmological assessment (BM, US and SD-OCT) was performed the day before surgery [8,13]. First independent investigator performed slit-lamp BM with fully dilated pupils using a 78D lens (Volk Optical Inc., Enterprise Drive Mentor, OH, USA).…”

“…First independent investigator performed slit-lamp BM with fully dilated pupils using a 78D lens (Volk Optical Inc., Enterprise Drive Mentor, OH, USA). A PVD was identi ed by the presence of a Weiss ring and or the de nitively detached visible posterior hyaloid membrane [8, 13,14]. It was classi ed as presence or absence of PVD on BM.…”

“…Status of PVD can usually be assessed by slit-lamp biomicroscopy (BM), B-scan ultrasonography (US), and optical coherence tomography (OCT), with varying degree of accuracy [8][9][10][11][12][13][14][15]. Biomicroscopy could be limited by patients' cooperation and examiner experience [8,14].…”