In a retrospective study, preoperative macular OCT identified macular pathology overlooked on fundus examination, and the findings led to management changes in a large percentage of patients.
Reviewed by Yishay Weill, MD
Results of a retrospective study support the routine use of macular optical coherence tomography (OCT) for preoperative screening of patients scheduled for cataract surgery, according to Yishay Weill, MD. The research evaluated data from 226 consecutive eyes of 226 patients referred to Shaare Zedek Medical Center, Jerusalem, Israel, for cataract surgery during the last two months of 2017.
It found that the macular OCT was normal in 51% of eyes and uninterpretable due to low quality in 9%. However, macular pathology was identified in 40% of the eyes. Importantly, the pathology was overlooked in the referral examination in 51% of the eyes with pathology, and its presence led to a change in management in 14% of patients.
“Cataract surgery is now a combined rehabilitative and refractive procedure, and our patients’ expectations are higher than ever,” said Dr. Weill, resident, Department of Ophthalmology, Shaare Zedek Medical Center. Dr. Weill noted that the dilated clinical fundus examination is currently considered the standard of care for preoperative evaluation of the macula.
“Its limited ability to detect pathology in patients with opaque media is a specific concern in the setting of patients presenting for cataract surgery,” he pointed out.
Dr. Weill also explained that overlooked macular pathologies might lead to suboptimal postoperative results, such as unexpected low BCVA and worsening of baseline macular pathology, and that will in turn could lead to dissatisfied patients.
Yishay Weil, MD
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This article is adopted from a presentation by Dr. Weill at AAO2018. He has no relevant financial interests to disclose.