Preoperative Widefield Swept-Source Optical Coherence Tomography Versus Intraoperative Findings in Detecting Posterior Vitreous Detachment.

PURPOSE

To assess the accuracy of swept-source optical coherence tomography (SS-OCT) in detecting complete posterior vitreous detachment (PVD) in comparison with intraoperative findings.

METHODS

The retrospective study included 145 eyes of 145 consecutive patients who underwent surgery for epiretinal membranes or macular holes. Within a week prior to surgery, PVD status was evaluated by SS-OCT with a depth of field of 3 mm and a capture window of 16 × 8 mm. Complete PVD was identified when the hyaloid condensation was visible clearly on any B-scan or when the vitreous cortex reflectivity was not visible on all 33 B-scans. Sensitivity, specificity, positive predictive value, and negative predictive value of SS-OCT for detection of complete PVD were then compared with those evaluated during a triamcinolone acetonide-assisted vitrectomy.

RESULTS

Of the 101 eyes diagnosed as complete PVD by SS-OCT preoperatively, 97 eyes were found to have complete PVD and four eyes were found to have attached vitreous intraoperatively. Of the 44 eyes categorized as attached vitreous by SS-OCT preoperatively, 43 eyes were graded as attached vitreous and one eye was graded as complete PVD during surgery. The sensitivity of SS-OCT for detecting complete PVD was 99.0% and the specificity was 91.5%. The positive predictive value and the negative predictive value were 96.0% and 97.7%, respectively.

CONCLUSIONS

Widefield (16 × 8 mm) SS-OCT showed high accuracy for the diagnosis of complete PVD in patients with epiretinal membranes or macular holes.

TRANSLATIONAL RELEVANCE

Widefield SS-OCT has great potential to evaluate PVD status preoperatively and explore the mechanisms of vitreoretinal diseases.