Use of intraoperative optical coherence tomography in vitreoretinal surgery for dense vitreous hemorrhage in Chinese population

Abstract

Purpose : To evaluate the feasibility and utility of intraoperative optical coherence tomography (iOCT) during pars plana vitrectomy (PPV) surgery for dense vitreous hemorrhage

Methods : A retrospective study. Sixty-eight patients (71 eyes)with dense vitreous hemorrhage.All the patients were divided into 2 groups: the iOCT group(28 eyes), the controlgroup (43eyes), according to whether iOCT was performed during the PPV surgery.All the patients had to undergo pars plana vitrectomy for dense hemorrhage whose macular structure couldn’t be assessed by preoperative OCT. Intraoperative OCT images were qualitatively evaluated for retinal abnormalities that might impact intraoperative management. The assessment of intraoperative OCT utility was also evaluated by Surgeon .

Results : Seventy-one eyes were included,the iOCT group of28 eyes, the control group of 43 eyes.There were no statistically significant differences in sex, age, the different etiologies of VH, BCVA between the twogroups at baseline. In the iOCT group,8 cases showed macular abnormalities on the iOCT images, which were inconsistent with the surgeon’s judgment witout iOCT. iOCT imaging impacted the surgical plan for 6 of the 8 cases (75%). In the iOCT group, macular membranes peeling such as ERM and ILM were performed in 11 eyes (39.3%), however, only 5 eyes (11.6%) in the control group. There was statistically significant difference between the 2 groups (x²=7.431, P=0.009). The incidence rate of maucar membrane was significant lower in the iOCT group ( no eye) than the control group (7 eyes) (Fisher exact test, P=0.037) at the first time of OCT scans postoperatively.

Conclusions : Intraoperative OCT during pars plana vitrectomy for vitreous hemorrhage may provide physicians with clinically relevant information that may impact surgical management.iOCT group have higher incidence of macular epiretinal membrane pelling intraoperatively and lower incidence of macular epiretinal membrane postoperatively.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Intraoperative OCT examples demonstrating lamellar macular hole that was not previously diagnosed until obtaining intraoperative imaging. A. B-scan showed lamellar macular hole (white arrow, Case 1).

 

B. B-scan showed macular hole after ILM peeling (white arrow, Case 1).