From the Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel, affiliated to the Hebrew University, Jerusalem, Israel.
J Cataract Refract Surg. 2021 Jan 1;47(1):78-82. doi: 10.1097/j.jcrs.0000000000000389.
To assess the clinical relevance of routine preoperative spectral-domain optical coherence tomography (SD-OCT) for identifying macular pathologies in patients scheduled for cataract surgery.
Shaare-Zedek Medical Center, Jerusalem, Israel.
Retrospective case series.
Consecutive patients, 50 years of age and older, scheduled for standard cataract extraction surgery were enrolled from November 2017 to January 2018. All study patients underwent routine SD-OCT scanning before cataract surgery. The scans were reviewed by a retinal specialist for macular pathology and compared with preoperative fundus biomicroscopic examination findings. The incidence of macular pathologies and changes in patient management as a result of the macular SD-OCT findings were assessed.
Four hundred fifty-three eyes of 453 patients were enrolled in the study; 42 eyes (9.2%) were excluded because of noninterpretable SD-OCT scans attributable to advanced cataract, leaving scans of 411 eyes of 411 patients for study inclusion. Macular pathologies were detected by SD-OCT in 167 eyes (40.6%), including age-related macular degeneration (50%), epiretinal membrane (28.3%), and cystoid macular edema (12.8%). Overall, the management of 107 patients (26.0%) was modified because of macular SD-OCT findings, which were either missed (22.8%) or underestimated (3.2%) by the fundus biomicroscopic examination. Changes in preoperative patient management included altering patient consultation regarding presbyopia correction solutions (73 eyes [17.8%]) and referral to a retinal specialist for consultation (34 eyes [8.3%]).
Routine macular SD-OCT scans for cataract surgery candidates helped to identify macular pathologies that might be missed or underestimated by standard fundus biomicroscopic examination. The added information could improve patient management.
评估术前频域光相干断层扫描（SD-OCT）常规检查在识别拟行白内障手术患者黄斑病变中的临床相关性。
以色列耶路撒冷的 Shaare-Zedek 医疗中心。
回顾性病例系列研究。
2017 年 11 月至 2018 年 1 月，连续招募年龄在 50 岁及以上、拟行标准白内障摘除术的患者。所有研究患者均在白内障手术前接受常规 SD-OCT 扫描。由一名视网膜专家对扫描结果进行检查，以评估黄斑病变，并与术前眼底生物显微镜检查结果进行比较。评估黄斑 SD-OCT 结果所致黄斑病变的发生率以及患者管理的变化。
本研究共纳入 453 例 453 只眼；因严重白内障导致 SD-OCT 扫描不可解读，42 只眼（9.2%）被排除，最终纳入 411 例患者的 411 只眼进行研究。SD-OCT 检测到 167 只眼（40.6%）存在黄斑病变，包括年龄相关性黄斑变性（50%）、视网膜内膜（28.3%）和黄斑囊样水肿（12.8%）。总体而言，由于黄斑 SD-OCT 检查结果，107 例（26.0%）患者的治疗方案发生改变，这些结果要么被眼底生物显微镜检查（22.8%）漏诊，要么低估（3.2%）。术前患者管理方案的改变包括改变对患者关于老视矫正方案的咨询（73 只眼[17.8%]）和转至视网膜专家进行咨询（34 只眼[8.3%]）。
拟行白内障手术患者的常规黄斑 SD-OCT 扫描有助于发现标准眼底生物显微镜检查可能遗漏或低估的黄斑病变。这些附加信息可以改善患者的管理。
