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白内障术前光学相干断层扫描的重要性。

Importance of optical coherence tomography before cataract surgery.

机构信息

Department of Ophthalmology, Yozgat City Hospital, Yozgat, Turkey.

出版信息

BMC Ophthalmol. 2024 Aug 12;24(1):339. doi: 10.1186/s12886-024-03622-3.

DOI:10.1186/s12886-024-03622-3
PMID:39135029
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11320843/
Abstract

PURPOSE

To determine the importance of optical coherence tomography (OCT) in patients scheduled for cataract surgery who present with no pathologies in biomicroscopic fundus examination.

DESIGN

Retrospective study.

METHODS

In this study, the routine ophthalmologic examination of patients who were recommended cataract surgery was performed.Occult retinal pathologies were evaluated using OCT in patients without any pathologies in biomicroscopic fundus examination.According to whether retinal pathologies were detected on OCT, the patients were divided into two groups: normal and abnormal OCT.The findings of patients with retinal pathologies on OCT and their distribution according to age were also evaluated.

RESULTS

A total of 271 eyes from 271 patients were evaluated.The number of patients with retinal pathologies on OCT despite normal fundoscopic examination findings was 38(14.0%).Of these patients,15(39.4%) had an epiretinal membrane,10(26.3%) had age-related macular degeneration, eight(21%) had vitreomacular traction, two(5.2%) had a lamellar hole, and 1(2.6%) patient each had a full-thickness macular hole, an intraretinal cyst, and photoreceptor layer damage.The age distribution of the patients with retinal pathologies was as follows: two patients,<60 years; six patients,60-70 years;14 patients,70-80 years; and 16 patients,>80 years.The rate of patients aged > 70 years and above was 78.9%.There was no statistically significant difference between the normal and abnormal OCT groups in terms of age, gender, the presence of systemic diseases, visual acuity, central macular thickness, and cataract type or density(p > 0.05 for all).

CONCLUSION

In one of seven patients evaluated, retinal pathologies were detected on OCT despite normal fundoscopic examination findings.OCT can be used to detect occult retinal pathologies that cannot be detected by biomicroscopic fundus examination before cataract surgery.

摘要

目的

确定在接受白内障手术的患者中,眼底镜检查无明显病理改变的情况下,光学相干断层扫描(OCT)的重要性。

设计

回顾性研究。

方法

本研究对建议行白内障手术的患者进行常规眼科检查。对眼底镜检查无明显病理改变的患者行 OCT 检查以评估隐匿性视网膜病变。根据 OCT 检查是否发现视网膜病变,将患者分为正常组和异常 OCT 组。评估 OCT 发现视网膜病变的患者及其根据年龄的分布情况。

结果

共评估了 271 例 271 只眼。尽管眼底镜检查正常,但 OCT 检查发现视网膜病变的患者有 38 例(14.0%)。这些患者中,15 例(39.4%)为视网膜前膜,10 例(26.3%)为年龄相关性黄斑变性,8 例(21%)为玻璃体黄斑牵拉,2 例(5.2%)为板层裂孔,1 例(2.6%)分别为全层黄斑裂孔、视网膜内囊、光感受器层损害。有视网膜病变患者的年龄分布如下:2 例患者<60 岁,6 例患者 60-70 岁,14 例患者 70-80 岁,16 例患者>80 岁。>70 岁的患者比例为 78.9%。正常 OCT 组和异常 OCT 组在年龄、性别、是否合并全身疾病、视力、黄斑中心凹厚度以及白内障类型或密度方面差异均无统计学意义(所有 P 值均>0.05)。

结论

在评估的患者中,有 1/7 的患者尽管眼底镜检查正常,但 OCT 检查发现了隐匿性视网膜病变。在白内障手术前,OCT 可用于检测眼底镜检查无法发现的隐匿性视网膜病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad9/11320843/69adc196f4c8/12886_2024_3622_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad9/11320843/ec2302c5d337/12886_2024_3622_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad9/11320843/69adc196f4c8/12886_2024_3622_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad9/11320843/ec2302c5d337/12886_2024_3622_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aad9/11320843/69adc196f4c8/12886_2024_3622_Fig2_HTML.jpg

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本文引用的文献

1
Optical coherence tomography as a diagnostic intervention before cataract surgery-a review.光学相干断层扫描在白内障术前诊断干预中的应用评价。
Eye (Lond). 2023 Aug;37(11):2176-2182. doi: 10.1038/s41433-022-02320-y. Epub 2022 Dec 14.
2
Patient management modifications in cataract surgery candidates following incorporation of routine preoperative macular optical coherence tomography.白内障手术患者在常规术前黄斑光学相干断层扫描后进行的患者管理调整。
J Cataract Refract Surg. 2021 Jan 1;47(1):78-82. doi: 10.1097/j.jcrs.0000000000000389.
3
Prevalence of macular abnormalities identified only by optical coherence tomography in Brazilian patients with cataract.
三焦点人工晶状体植入治疗轻度病理性近视:视觉效果及眼底结构的影响
BMC Ophthalmol. 2025 Mar 4;25(1):108. doi: 10.1186/s12886-025-03931-1.
4
Screening for Occult Macular Pathology Prior to Cataract Surgery Using Optical Coherence Tomography.使用光学相干断层扫描在白内障手术前筛查隐匿性黄斑病变
Clin Ophthalmol. 2025 Jan 31;19:317-324. doi: 10.2147/OPTH.S507995. eCollection 2025.
巴西白内障患者中仅通过光学相干断层扫描发现的黄斑病变的患病率。
J Cataract Refract Surg. 2019 Jul;45(7):915-918. doi: 10.1016/j.jcrs.2019.01.022. Epub 2019 Jun 4.
4
Optical coherence tomography findings in patients prior to cataract surgery regarded as unremarkable with ophthalmoscopy.在眼科检查中被认为无明显异常的白内障手术患者的光学相干断层扫描结果。
PLoS One. 2018 Dec 11;13(12):e0208980. doi: 10.1371/journal.pone.0208980. eCollection 2018.
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Preoperative evaluation for cataract surgery.白内障手术的术前评估。
Curr Opin Ophthalmol. 2019 Jan;30(1):3-8. doi: 10.1097/ICU.0000000000000535.
6
Incorporating Optical Coherence Tomography in the Cataract Preoperative Armamentarium: Additional Need or Additional Burden?将光学相干断层扫描纳入白内障术前设备中:是额外的需要还是额外的负担?
Am J Ophthalmol. 2019 Feb;198:209-214. doi: 10.1016/j.ajo.2018.10.025. Epub 2018 Oct 31.
7
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J Cataract Refract Surg. 2018 May;44(5):610-614. doi: 10.1016/j.jcrs.2018.02.020. Epub 2018 May 8.
8
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