Swept-source optical coherence tomography to screen for macular pathology in eyes having routine cataract surgery

Abstract

Purpose: To determine the incremental benefit of swept-source optical coherence tomography (SS-OCT) in identifying occult macular disease preoperatively in patients scheduled for routine cataract surgery.

Setting: Shahzad Eye Hospital, Karachi, Pakistan.

Design: Prospective case series.

Methods: Preoperative SS-OCT scans were performed in all patients scheduled to have cataract surgery between January and March 2016. Scans were subsequently reviewed for the presence of macular abnormalities. Patients with clinically detectable retinal pathologies were excluded.

Results: Of the 179 eligible patients, 155 were included in the study. Macular pathology was noted in 17 patients (10.9%). The most commonly identified conditions were age-related macular degeneration (n = 5), idiopathic epiretinal membrane (n = 4), and vitreomacular interface abnormalities (n = 4). Other abnormalities included cystoid macular edema (n = 2) and ellipsoid zone abnormalities (n = 2). Media opacities precluded interpretation of 9 scans (4.7%).

Conclusions: Swept-source OCT was an effective noninvasive modality for detecting macular structural abnormalities, especially in the presence media opacities. Optical coherence tomography imaging should be considered as an adjunct to routine dilated fundus examination for macular evaluation, particularly if premium intraocular lenses are being considered.