Intraoperative OCT for Uveitis-Related Vitreoretinal Surgery in the DISCOVER Study

Abstract

To evaluate the feasibility and usefulness of intraoperative OCT (iOCT) for uveitis-related vitreoretinal surgeries. Prospective consecutive case series. Seventy-three consecutive patients (74 eyes) with a uveitis-related diagnosis. Eyes undergoing surgery for a uveitis-related diagnosis in the prospective Determination of Feasibility of Intraoperative Spectral Domain Microscope Combined/Integrated OCT Visualization During En Face Retinal and Ophthalmic Surgery (DISCOVER) iOCT study. Intraoperative OCT was performed at various surgical milestones. Clinical details and evaluation of the role of iOCT were assessed. A standardized surgeon survey was completed to evaluate the usefulness of iOCT during surgery. Percentage of patients in whom iOCT provided valuable feedback and altered surgical decision making. Seventy-four consecutive eyes with a uveitis-related diagnosis were enrolled in the DISCOVER study. Successful imaging was obtained in 72 of 73 eyes (98.6%). Intraoperative OCT provided valuable feedback for fluocinolone acetonide implant placement in 11 of 13 eyes (84.6%), for chorioretinal biopsies in 13 of 16 eyes (81.2%), and for retinal detachment (RD) repairs in 20 of 27 eyes (74.1%). In subretinal and chorioretinal biopsies, iOCT altered surgical decision making in 38% of patients. In uveitis-related RD repairs, iOCT resulted in alterations in the surgical procedure in 48% of patients, predominantly related to additional membrane peeling. Intraoperative OCT during uveitis-related vitreoretinal surgery seems to provide valuable additional information that can impact surgical decision making and may enhance outcomes.