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Intraoperative OCT provides information on otherwise unseen features in highly myopic eyes
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VIENNA — Intraoperative OCT is a technology in evolution, with benefits for research and limited but significant advantages for daily surgical practice, according to one surgeon speaking at the Advanced Retinal Therapy meeting.
Looking at OCT during procedures such as membrane peeling, vitreomacular traction and macular hole surgery gives no meaningful information because no measurable changes occur in the retina. However, when dealing with highly myopic eyes, iOCT may provide information not given by fundus imaging, Ramin Tadayoni, MD, PhD, said.
Ramin Tadayoni
In a study of 22 consecutive myopic eyes undergoing vitreoretinal surgery for different indications, a Rescan 700 iOCT (Carl Zeiss Meditec) was used for quantitative and qualitative assessment.
“No significant quantitative retinal changes were found, but qualitatively we were able to get interesting information only detectable on iOCT scans,” Tadayoni said.
An inner retinal defect was detected in one eye operated for myopic epiretinal membrane, and a peeling-induced macular opening was visible in one eye with myopic foveoschisis.
“Macular holes are one of the main complications of myopic eyes undergoing surgery, with a rate of 18%. Early detection may lead to better management,” Tadayoni said.
In difficult cases with limited visibility, as often is the case with highly myopic eyes, iOCT can provide useful additional information, he said.
“It is very reassuring for surgeons and may help avoid supplementary maneuvers and the related complications. In addition, it is good to have a first postoperative OCT right at the end of the surgery,” he said.
Intraoperative OCT is still a work in progress, and today it is a “clinical OCT in the microscope,” he said.
“We should redesign it for surgery. Whether it is a revolution, the future will tell,” he said.
Reference:
Tadayoni R. Is intraoperative OCT a break-through? Presented at Advanced Retinal Therapy meeting; Dec. 3, 2016; Vienna.
Disclosure : Tadayoni reports he is a consultant to Carl Zeiss Meditec.