September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Intraoperative assessment of retinal morphological changes using microscope-integrated optical coherence tomography during vitreomacular surgery.
Author Affiliations & Notes
  • Pauline Nguyen Kim
    ophthalmology, Lariboisiere hospital, Paris, France
  • Aude Couturier
    ophthalmology, Lariboisiere hospital, Paris, France
  • Benedicte Marie Dupas
    ophthalmology, Lariboisiere hospital, Paris, France
  • Ramin Tadayoni
    ophthalmology, Lariboisiere hospital, Paris, France
  • Footnotes
    Commercial Relationships   Pauline Nguyen Kim, None; Aude Couturier, None; Benedicte Dupas, None; Ramin Tadayoni, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5830. doi:
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      Pauline Nguyen Kim, Aude Couturier, Benedicte Marie Dupas, Ramin Tadayoni; Intraoperative assessment of retinal morphological changes using microscope-integrated optical coherence tomography during vitreomacular surgery.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5830.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe macular morphological changes occurring during vitreomacular surgery detected by microscope-integrated intraoperative Optical Coherence Tomography (iOCT).

Methods : Consecutive eyes that underwent 25G vitrectomy with iOCT imaging (RESCAN 700, Carl Zeiss Meditec AG) for epiretinal membrane (ERM) or full-thickness macular hole (MH) from December 2014 to May 2015 were retrospectively reviewed. Highly myopic eyes were excluded. Retinal morphological changes were assessed qualitatively and quantitatively. Quantitative measurements (in pixels) were manually obtained on iOCT video screen captures and included the central macular thickness (CMT) in ERM and minimal horizontal and base diameters in MH throughout the surgical procedure.

Results : Thirty eyes were included: 20 eyes with ERM and 10 eyes with MH. Qualitative iOCT image analysis showed that the posterior vitreous cortex elevation and epiretinal structure peeling (ERM and/or internal limiting membrane) induced an acute traction on the retinal surface without any significant alteration of the macular morphology. This was confirmed by quantitative analysis, showing that in ERM surgery, the CMT measured on iOCT images after ERM and/or ILM peeling (74.0 ± 21.1pixels) did not significantly differ from pre-peeling CMT (76.3± 21.4pixels; p=0.079). Similarly, during MH surgery, the MH minimal horizontal diameter and base diameter after posterior vitreous cortex elevation and/or ILM peeling (mean 24.3 ± 9.0 pixels and 61.3 ± 16.7 pixels, respectively) did not significantly differ from initial MH horizontal and base diameters (27.1 ± 12.3 pixels and 60.7 ± 17.9 pixels; p = 0.181 and 0.771, respectively).

Conclusions : This first quantitative iOCT study in vitreomacular diseases showed that CMT or MH diameters measured on iOCT images did not significantly change throughout the surgical procedure. This finding has a semiotic value and also demonstrates retinal resistance to common surgically induced acute traction on the retina.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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