Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Ocular Trauma and Emergency Department, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Am J Ophthalmol. 2020 Aug;216:55-58. doi: 10.1016/j.ajo.2020.03.030. Epub 2020 Apr 2.
To assess the efficacy of swept-source optical coherence tomography (SS-OCT) and ultrasound biomicroscopy (UBM) in detecting posterior capsule (PC) defect in patients with traumatic cataract.
Observational case-series.
Sixty-seven eyes from 67 patients, with traumatic cataract severe enough to prevent slit lamp evaluation of the PC, were included in a simple sequence without randomization. Patients underwent both 50-MHz UBM and SS-OCT evaluation of the PC by different operators. Cataract surgery was then performed using a single technique.
Sixty-seven eyes from 67 patients including 60 men and 7 women were studied. The mean age was 34 ± 14 years and the mean logarithm of minimal angle of resolution of visual acuity was 1.89 ± 0.71. The calculated sensitivity, specificity, and accuracy values for SS-OCT were 96.8% (95% confidence interval [CI] 83.81-99.43), 66.7% (95% CI 48.78-80.77), and 82% (95% CI 70.53-89.62), respectively. For UBM, sensitivity, specificity, and accuracy values were 82.6% (95% CI 62.86-93.02), 57.9% (95% CI 36.28-76.86), and 71.4% (95% CI 56.43-82.83), respectively. Positive predictive and negative predictive values for SS-OCT were 75% (95% CI 59.81-85.81) and 95.2% (95% CI 77.33-99.15) and for UBM were 70.4% (95% CI 51.52-84.15) and 73.3% (95% CI 48.05-89.1), respectively.
Although both imaging techniques are effective, SS-OCT appears to be at least comparable, or superior in special circumstances, to UBM in detecting preoperative posttraumatic PC rupture. We recommend preoperative assessment of all traumatic cataracts with SS-OCT as a part of surgical planning.
评估扫频源光学相干断层扫描（SS-OCT）和超声生物显微镜（UBM）在检测外伤性白内障患者后囊（PC）缺损中的疗效。
观察性病例系列。
纳入了 67 名患者的 67 只眼，这些患者的外伤性白内障严重到无法通过裂隙灯检查 PC，这是一个没有随机分组的简单序列。由不同的操作者对患者进行 50MHz UBM 和 SS-OCT 的 PC 评估。然后使用单一技术进行白内障手术。
纳入了 67 名患者的 67 只眼，其中 60 名男性和 7 名女性，平均年龄为 34±14 岁，平均最小分辨角视力对数为 1.89±0.71。SS-OCT 的计算灵敏度、特异性和准确率分别为 96.8%（95%置信区间 83.81-99.43）、66.7%（95%置信区间 48.78-80.77）和 82%（95%置信区间 70.53-89.62）。UBM 的灵敏度、特异性和准确率分别为 82.6%（95%置信区间 62.86-93.02）、57.9%（95%置信区间 36.28-76.86）和 71.4%（95%置信区间 56.43-82.83）。SS-OCT 的阳性预测值和阴性预测值分别为 75%（95%置信区间 59.81-85.81）和 95.2%（95%置信区间 77.33-99.15），UBM 的阳性预测值和阴性预测值分别为 70.4%（95%置信区间 51.52-84.15）和 73.3%（95%置信区间 48.05-89.1）。
虽然两种成像技术都有效，但在特殊情况下，SS-OCT 在检测外伤性 PC 破裂方面至少与 UBM 一样有效，甚至更优。我们建议将 SS-OCT 作为手术计划的一部分，对所有外伤性白内障进行术前评估。
