Abstract
Purpose:To report the use of intraoperative spectral domain optical coherence tomography (SD-OCT) for detecting anatomical changes during macular surgery.Methods:In a consecutive case series, 32 eyes of 32 patients undergoing concurrent pars plana vitrectomy and intraoperative SD-OCT for macular hole (MH), epiretinal membrane (ERM) and vitreomacular traction (VMT) were enrolled. Intraoperative changes in retinal thickness and dimensions of the macular hole were measured in patients with ERM and VMT following surgical manipulation using a hand-held SD-OCT device (iVue, Optovue Inc., Fremont, CA, USA).Results:SD-OCT images of sixteen eyes with macular hole were subjected to quantitative and qualitative analysis. All MH dimensions remained stable during consecutive stages of surgery except for MH apex diameter, which showed a significant decrease after internal limiting membrane (ILM) peeling (P=0.025). Quantitative analysis of ten patients with ERM showed a significant decrease in retinal thickness after membrane removal (P=0.018) which did not remain significant until the end of the procedure (P=0.8). In three cases, subretinal fluid was formed after ILM peeling. Quantitative analysis of five patients with VMT showed a decrease in retinal thickness during consecutive steps of the surgery, although these changes were not significant. In two cases, subretinal fluid was formed after ILM peeling.Conclusion:Intraoperative SD-OCT is a useful imaging technique which provides vitreoretinal surgeons with rapid awareness of changes in macular anatomy during surgery and may therefore result in better anatomical and visual outcomes.
Highlights
We evaluated the role of intraoperative hand-held spectraldomain optical coherence tomography (SD-OCT) in detecting changes in retinal anatomy during different stages of macular surgeries in 32 eyes suffering from macular hole (MH), epiretinal membrane (ERM) and vitreomacular traction (VMT) syndrome
In our sixteen cases of macular hole, while we observed a decrease in MH apex diameter after internal limiting membrane (ILM) peeling while no significant change was noted in MH base diameter and height
These findings are in contrast to those reported by Ray et al who found an increase in MH base diameter and found no change in MH apex diameter.[14]
Summary
Optical coherence tomography has gained an important role in the diagnosis, management and follow-up of Correspondence to: Received: 01-12-2014. All emerging data have fruitfully shown significant. Macular surgery using intraoperative spectral domain optical coherence tomography.
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