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Dominic Heinrich, Sabrina Bohnacker, M. Ali Nasseri, Nikolaus Feucht, Chris Lohmann, Mathias M Maier; Use of intraoperative Optical Coherence Tomography (i-OCT) in vitreous haemorrhage due to diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5010.
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© ARVO (1962-2015); The Authors (2016-present)
High resolution spectral Domain OCT (SD-OCT) is a gold standard technique in diagnosis, management and monitoring of patients with vitreoretinal diseases. Since preoperative diagnostics for the evaluation of intraocular and retinal status in patients with vitreous haemorrhage due to diabetic retinopathy are limited, final therapeutic decisions can only be made during explorative vitrectomy. We evaluated the use of i-OCT as a real-time additional diagnostic tool during surgery.
We examined 20 patients with vitreous haemorrhage due to diabetic retinopathy. Due to the limited view of the posterior segment prior to surgery, ultrasound was performed. During vitrectomy, intraoperative real-time OCT was applied as an additional diagnostic tool to optimise the surgical workflow.Exemplarily, we present the case of a 69 y/o female with vitreous haemorrhage due to diabetic retinopathy on the right eye. Visual acuity was “hand motion”. Preoperative funduscopy was not possible due to very dense vitreous haemorrhages. Sonographically, there were no signs of retinal detachment was identified on the right eye. Vitrectomy was performed and intraoperative OCT was applied to evaluate the macula and the retina.
In all patients, intraoperative OCT allowed real-time evaluation of the retinal status. Further surgical strategy (i.e. necessity for ERM or ILM peeling) was based on the intraoperative OCT. The decision for the postoperative tamponade was facilitated.In the patient described above, the i-OCT showed an epiretinal membrane. Therefore, the surgical strategy was adjusted and ERM peeling was performed on the right eye. Three months after surgery, funduscopy and central OCT scan still show irregularities in the macular configuration. However, visual acuity was already 0,6.
Intraoperative OCT is highly useful as additional intraoperative diagnostic tool in patients with vitreous haemorrhage due to diabetic retinopathy. It facilitates real-time diagnosis and promotes therapeutic decisions during surgery.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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