Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Eastern Road, Brighton, BN2 5BF, UK.
Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton, BN1 9PX, UK.
Eye (Lond). 2023 Mar;37(4):665-669. doi: 10.1038/s41433-022-02027-0. Epub 2022 Mar 24.
To assess the proportion of maculopathy detectable only on optical coherence tomography (OCT) versus slit lamp indirect ophthalmoscopy (SLIO) during cataract assessment.
Population: Consecutive patients attending cataract assessments.
All patients underwent OCT and SLIO. SLIO findings were recorded before reviewing OCT. Scans were examined to compare with recorded SLIO findings.
analyse the proportion of eyes with maculopathy missed by SLIO.
to assess the proportion of patients with maculopathy on OCT, the incidence of maculopathy in the fellow eye on OCT and proportion with cataracts too dense to allow SLIO or OCT.
Six hundred twenty-six patients were enroled. Eighty (12.8%) had maculopathy detectable only on OCT which included: 26 (4.2%) epiretinal membrane (ERM), 25 (4%) dry age-related macular degeneration (AMD), 19 (3%) vitreomacular traction (VMT), 5 (0.8%) lamellar macular hole (LMH), 2 (0.3%) cystoid macular oedema (CMO) and 1 (0.2%) wet AMD. 166 (26.5%) had maculopathy on OCT, of which only 48 (7.7%) had known history of maculopathy. In fellow eyes, 29 (4.6%) had significant findings and 29 (4.6%) were unable to have SLIO or OCT due to dense cataract.
A quarter of the patients had occult maculopathy. One-tenth of the occult maculopathy were missed without OCT, with ERM, dry AMD, VMT, LMH, CMO and wet AMD being the primary missed diagnosis. Less than 5% had occult maculopathy in fellow eye, and <5% had dense cataracts where neither SLIO nor OCT was not possible.
评估在白内障评估过程中仅在光学相干断层扫描（OCT）上检测到而在裂隙灯间接检眼镜（SLIO）上检测不到的黄斑病变的比例。
人群：连续接受白内障评估的患者。
所有患者均接受 OCT 和 SLIO 检查。在查看 OCT 之前记录 SLIO 检查结果。对扫描结果进行检查以与记录的 SLIO 结果进行比较。
分析 SLIO 漏诊的黄斑病变眼的比例。
评估 OCT 上的黄斑病变患者比例、OCT 上对侧眼的黄斑病变发生率以及因白内障太密集而无法进行 SLIO 或 OCT 的患者比例。
共纳入 626 例患者。80 例（12.8%）仅在 OCT 上检测到黄斑病变，包括：26 例（4.2%）视网膜前膜（ERM）、25 例（4%）干性年龄相关性黄斑变性（AMD）、19 例（3%）玻璃体黄斑牵引（VMT）、5 例（0.8%）板层黄斑裂孔（LMH）、2 例（0.3%）囊样黄斑水肿（CMO）和 1 例（0.2%）湿性 AMD。166 例（26.5%）在 OCT 上有黄斑病变，其中只有 48 例（7.7%）有已知的黄斑病变史。在对侧眼中，29 例（4.6%）有明显病变，29 例（4.6%）因白内障过密而无法进行 SLIO 或 OCT。
四分之一的患者存在隐匿性黄斑病变。如果没有 OCT，十分之一的隐匿性黄斑病变会被漏诊，ERM、干性 AMD、VMT、LMH、CMO 和湿性 AMD 是主要漏诊的病变。对侧眼隐匿性黄斑病变少于 5%，因白内障过密而无法进行 SLIO 或 OCT 的患者少于 5%。
