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Elsa Bruyere, Aude Couturier, Elise Philippakis, Benedicte Marie Dupas, Ramin Tadayoni; Intraoperative optical coherence tomography analysis of vitreomacular diseases in high myopia. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4455. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Intraoperative Optical Coherence Tomography (iOCT) may be of particular interest in highly myopic eyes whose fundus analysis may be impaired by posterior staphyloma and chorioretinal atrophy, and which have a higher risk of abnormal posterior vitreous detachment and surgical complications. The aim of this study was to describe and analyze changes occurring during vitreomacular surgery in highly myopic eyes detectable by iOCT.
A retrospective observational analysis was performed on consecutive highly myopic eyes (refractive error <-6,00D, Axial length >26 mm) that underwent vitreomacular surgery with iOCT (RESCAN 700, Carl Zeiss Meditec AG). Surgical indications were myopic epiretinal membrane (ERM), macular hole (MH) and foveoschisis (MFS). The main outcome was the qualitative and quantitative assessment of retinal changes: opening detection, central macular thickness (CMT) changes after peeling in ERM and MFS, minimal diameter changes in MH, after each step of the surgical procedure. Quantitative measurements (in pixels) were manually obtained on iOCT video screen captures.
Twenty-two eyes were included: 6 ERM, 10 MH and 6 MFS. Qualitative analysis of post-peeling iOCT scans allowed detecting a macular opening in 1 eye operated for MFS and an inner retinal defect in 1 eye operated for ERM. Quantitative analysis of post-peeling iOCT scans in ERM and MFS detected no significant change in CMT after ERM and ILM peeling compared to pre-peeling CMT: mean CMT was 51.2 ± 8.1 pixels and 77.8 ± 13.6 pixels before ERM and ILM peeling, respectively, versus 51.0 ± 6.0 pixels and 77.2 ± 13.1 pixels after ERM and ILM peeling, respectively (p= 0.97 and 0.93). Regarding MH, no significant change in mean MH minimal horizontal (19.5 ± 4.3 pixels) or base diameters (51.7 ± 18.4 pixels) was detected after ILM peeling compared to mean pre-peeling MH horizontal and base diameters (20.7 ± 5.0 pixels; p=0.57 and 53.1 ± 14.6 pixels; p=0.86, respectively).
In highly myopic eyes, iOCT allowed accurately visualizing surgically induced retinal changes. This could help to assess post-peeling complications, in particular foveal opening. Conversely, this first quantitative iOCT study in highly myopic eyes did not show a significant change in CMT or MH diameters during surgical procedure.
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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