Raquel Goldhardt1, Bradley Simon Rosen2. 1. Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, 900 NW 17 Street, Miami, FL, 33136. 2. Private Practice. Los Angeles, CA, 90292.
Abstract
PURPOSE OF REVIEW: To review evidence on the utility of spectral domain optical coherence tomography (SD-OCT) in evaluating retinal structure prior cataract surgery and highlight new technologies that can assess retinal function perioperatively. FINDINGS: SD-OCT detected clinically unsuspected macular pathology in 4.6-25% of individuals in the pre-operative cataract evaluation. The most common findings were epiretinal membrane and macular degeneration with frequencies that varied by population studied. These conditions have been associated with complication after surgery (e.g. macular edema, visual dissatisfaction). As such, findings on SD-OCT may impact the informed consent process, alter IOL selection, and provide realistic postoperative vision expectations. Other technologies that assess retinal function, such as microperimetry and multifocal ERG are beginning to be studied but their utility in the pre-operative cataract evaluation is not yet known. SUMMARY: SD-OCT should be incorporated as a routine test prior to surgery to manage patient expectations and assist with optimal IOL selection, as even individuals with a seemingly normal clinical exam may have macular pathology. SD-OCT is the most established method for evaluating retinal anatomy and offers the benefits of a reduction in cases with missed macular pathology and fewer postoperative visual surprises.
PURPOSE OF REVIEW: To review evidence on the utility of spectral domain optical coherence tomography (SD-OCT) in evaluating retinal structure prior cataract surgery and highlight new technologies that can assess retinal function perioperatively. FINDINGS: SD-OCT detected clinically unsuspected macular pathology in 4.6-25% of individuals in the pre-operative cataract evaluation. The most common findings were epiretinal membrane and macular degeneration with frequencies that varied by population studied. These conditions have been associated with complication after surgery (e.g. macular edema, visual dissatisfaction). As such, findings on SD-OCT may impact the informed consent process, alter IOL selection, and provide realistic postoperative vision expectations. Other technologies that assess retinal function, such as microperimetry and multifocal ERG are beginning to be studied but their utility in the pre-operative cataract evaluation is not yet known. SUMMARY: SD-OCT should be incorporated as a routine test prior to surgery to manage patient expectations and assist with optimal IOL selection, as even individuals with a seemingly normal clinical exam may have macular pathology. SD-OCT is the most established method for evaluating retinal anatomy and offers the benefits of a reduction in cases with missed macular pathology and fewer postoperative visual surprises.
Authors: Carlos Augusto Moreira Neto; Carlos Augusto Moreira Júnior; Ana Tereza Ramos Moreira Journal: Arq Bras Oftalmol Date: 2015 Jul-Aug Impact factor: 0.872
Authors: Sergio Copete; Pablo Martí-Rodrigo; Romina Muñiz-Vidal; Salvador Pastor-Idoate; Jaume Rigo; Marta S Figueroa; José García-Arumí; Miguel A Zapata Journal: Retina Date: 2019-11 Impact factor: 4.256