Abstract
Purpose :
Limited research is available on the role for intraoperative OCT (iOCT) in vitreomacular traction (VMT). The goal of this study is to characterize the clinical/anatomic outcomes and utility of iOCT-assisted surgical intervention for VMT.
Methods :
The DISCOVER study is a prospective study evaluating the role of iOCT in ophthalmic surgery. This was a post-hoc analysis of eyes in the DISCOVER study undergoing pars plana vitrectomy (PPV) for macular disease with associated VMT. During surgery, iOCT was obtained and reviewed. Surgeons completed standardized questionnaires evaluating the feasibility and utility of iOCT after each operation. Functional and anatomical data were collected through 12 months post-operatively, as available. Subjects with less than 3 months follow-up were excluded. Multi-layer OCT segmentation was performed for panmacular and central macular features. Student’s t-test and Pearson correlation tests were performed.
Results :
Forty-three eyes of 41 patients were included in this analysis with a mean age of 72.2 ± 8.4 years with median follow-up time of 42 weeks. Thirty-one eyes had associated macular hole. The mean preoperative visual acuity (VA) was 20/96 and improved to 20/45 at final visit (p < 0.001). iOCT provided valuable feedback, such as identification of residual membranes and confirmation of membrane peel, in 24 cases (55.8%) and informed surgical decision-making in 8 cases (18.6%). Ellipsoid zone (EZ) integrity metrics, including mean EZ-retinal pigment epithelium (RPE) central subfield thickness and volume (p < 0.001), and EZ-RPE partial (p = 0.01) and total (p = 0.03) attenuation significantly improved from baseline to 12 months. Improvements in EZ integrity, as measured by macular EZ-RPE volume, directly correlated with final visual acuity (r = 0.7, p < 0.001).
Conclusions :
Retinal function and morphology improved significantly following iOCT-assisted PPV for VMT. iOCT provided surgeon-perceived valuable information in a high proportion of cases.
This is a 2020 ARVO Annual Meeting abstract.