Macular assessment of preoperative optical coherence tomography in ageing Chinese undergoing routine cataract surgery

Xiaoli Huang,Xiaomei Meng,Zhengwei Zhang,Jie Wang,Zhifeng Wu,Tiantian Chen

doi:10.1038/s41598-018-22807-7

Abstract

This retrospective consecutive case series aimed to evaluate spectral-domain optical coherence tomography (SD-OCT) for occult macular disease recognition preoperatively in patients scheduled for routine cataract surgery. All patients scheduled for cataract surgery underwent macular SD-OCT. Scans were reviewed for retinal, retinal pigment epithelium and vitreomacular interface abnormalities. For the subgroup analysis, the following information was collected: age; sex; and diabetes, hypertension, myopia, glaucoma, post intra-ocular surgery, endophotocoagulation, retinal vasculopathy and uveitis statuses. One-thousand-one-hundred-seventy-six consecutive scans were acquired from 1,176 patients. Macular pathology was found in 294 eyes. The most common macular disorders were an epiretinal membrane (n = 130), myopia atrophy (n = 61) and a dome-shaped macular with pathologic myopia (n = 32). One-hundred-thirty eyes (11.05%) presented macular epiretinal membranes not detected by dilated fundus examination, accounting for 44.22% of the abnormalities in diseased eyes and was higher than in previous Chinese studies. Some had multiple macular disorders. The most common ocular history was myopia, including high myopia. The pooled prevalence rate of macular diseases detected by OCT was 0.24 (95% CI 0.14–0.34) using meta-analysis. SD-OCT should be performed for routine cataract surgery patients to evaluate visual outcomes, especially in myopic patients and those considering advanced-technology intraocular lenses.

Highlights

China has a population of 1.3 billion accounting for 15% of the world’s population
In order to recognize occult macular diseases preoperatively in patients scheduled for routine cataract surgery, we evaluated the macular structures of all patients before cataract surgery with Spectral-domain optical coherence tomography (SD-OCT)
All 1,176 eyes in the 1,176 patients scheduled for routine cataract surgery during the study underwent a preoperative SD-OCT scan, of whom 685 were women

Summary

Introduction

The estimated prevalence of blindness in individuals aged ≥50 years was 2.3% in 20101. The prevalence of low vision and blindness in Chinese adults remains a severe public health concern. Cataract was the primary cause of visual impairment in adults aged ≥45 years. Suboptimal visual outcomes after uneventful cataract surgery can cause substantial patient dissatisfaction, especially in cases of missed macular pathology[4]. As approximately 2,000 patients undergo cataract surgery at our hospital each year, improvements in understanding the visual prognosis and management of these cases could confer a substantial benefit to both patients and surgeons. In order to recognize occult macular diseases preoperatively in patients scheduled for routine cataract surgery, we evaluated the macular structures of all patients before cataract surgery with SD-OCT

Methods

Results

Conclusion