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New SD-OCT classification system introduced for vitreomacular interface disorders
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TORONTO — A new international classification system for vitreomacular interface disorders based on spectral-domain optical coherence tomography imaging was introduced by a speaker here.
During the OCTIPER symposium preceding the American Society of Retina Specialists meeting, Jay S. Duker, MD, an OSN Retina Editorial Board member, introduced the new classification for vitreomacular adhesion, vitreomacular traction, full-thickness macular hole, lamellar macular hole and epiretinal membrane, based on objective SD-OCT image analysis.
Jay S. Duker
“With respect to the diseases of the vitreomacular interface, there is really only one imaging technique that you need to think about and that is spectral-domain OCT,” Duker said.
All of the vitreomacular interface diseases are associated with an anomalous posterior vitreous detachment, he said. “In the past couple of years we have come to understand this a lot better.”
An international panel of 10 retina specialists was convened at the American Society of Retina Specialists in 2012 to develop the new classification system, Duker said.
The goals for the new classification were to create an easy-to-use and easy-to-remember system objectively based solely on OCT images that would be clinically applicable, help make surgical outcomes more predictable and be useful in clinical trials, he said.
“We needed a classification system that would allow the retina community to speak a common language,” Duker said. “When you go through the literature and look at some of the labels that have been put on these various diseases, they are inconsistent, and it is hard to tell when people are talking about the same things.”
The advent of SD-OCT has also given clinicians the ability to image “clinically invisible” structures, such as the posterior hyaloid, vitreous adhesions and small retinal cysts and holes, Duker said.
“SD-OCT is invaluable for the diagnosis and management of these diseases,” Duker said. “OCT can visualize subtle findings that may be impossible to see clinically.”
Disclosure: Duker receives research support from OptoVue and Carl Zeiss Meditec and is a consultant to ThromboGenics and Alcon.