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Optical coherence tomography as a diagnostic intervention before cataract surgery—a review

Eye volume 37, pages 2176–2182 (2023)Cite this article

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Abstract

The purpose of this study was to perform a systematic review of existing literature on OCT screening before cataract surgery. Available literature was evaluated and projections on how it could be applied to enhance postoperative outcomes of cataract surgery were summarised. The PubMed, Embase and Cochrane databases were searched for articles pertaining to preoperative OCT screening. Selected articles were qualitatively and quantitatively analysed. Across 9 studies, the addition of OCT macular screening resulted in preoperative detection of macular pathology in 13.7% of eyes that were determined to be normal on fundoscopic examination alone. The types of macular pathology most frequently detected through preoperative OCT screening were interface abnormalities followed by macular degeneration. Comparative analysis of SS-OCT biometer and SD-OCT found that SS-OCT had a sensitivity of 0.48–0.81 in the detection of macular pathology in eyes with pathology diagnosed by SD-OCT. OCT screening prior to cataract surgery results in the detection of occult macular pathology that may influence postoperative visual outcomes in approximately 1 in 10 eyes (13.7%). As a result, OCT screening should be considered in the routine preoperative workup for cataract surgery.

摘要

本文旨在对白内障术前的OCT对眼底筛查的现有文献进行系统综述。对现有文献进行了评估, 并总结了将其应用在白内障术后的预测的方法。

我们检索了PubMed, Embase和Cochrane数据库中与白内障术前OCT对眼底病变筛查相关的文献。对选定的文章进行了定性和定量分析。

在九项研究中, OCT可筛查出13.7%的黄斑病变患者, 而这些患者仅通过眼底镜检查时诊断为正常。通过术前OCT筛查到最多的黄斑病变类型是玻璃体视网膜交界面异常, 其次是黄斑病变。通过比较SS-OCT和SD-OCT可以发现, SS-OCT对SD-OCT诊断的黄斑病变的检测敏感性为0.48-0.81。白内障术前的OCT筛查可发现隐匿性黄斑病变, 这可能会影响术后约1/10 (13.7%) 患者的视力预后。因此, 本文的结果强烈推荐OCT作为白内障术前的常规术前检查。虽然SS-OCT确实有所帮助, 但SD-OCT仍然是白内障患眼术前诊断的黄金标准。

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Fig. 1: A flowchart of the study selection process.
Fig. 2: Options for potential application of OCT screening among patients undergoing cataract surgery.

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Authors and Affiliations

  1. Aga Khan University Medical College, Karachi, Pakistan

    Taha Muneer Ahmed

  2. Department of Ophthalmology and Visual Sciences, Aga Khan University Hospital, Karachi, Pakistan

    M. A. Rehman Siddiqui

  3. Moorfields Eye Hospital, London, UK

    Badrul Hussain

Authors
  1. Taha Muneer Ahmed
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  2. M. A. Rehman Siddiqui
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  3. Badrul Hussain
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Contributions

TMA was responsible for conducting the search, screening potentially eligible studies, extracting. and analysing data, writing the report, interpreting results, updating reference lists and creating ‘Summary of findings’ tables. MARS and BH were responsible for designing the review protocol, screening potentially eligible studies and providing feedback on the manuscript. All the authors reviewed and approved the final manuscript.

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Correspondence to M. A. Rehman Siddiqui.

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Ahmed, T.M., Siddiqui, M.A.R. & Hussain, B. Optical coherence tomography as a diagnostic intervention before cataract surgery—a review. Eye 37, 2176–2182 (2023). https://doi.org/10.1038/s41433-022-02320-y

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