OCT Before Cataract Surgery
John R Martinelli MD OD FAAO
Teaching The Fine Art of Patient Management
Yes or No?...
Optical coherence tomography (OCT) can be a valuable tool screening for hidden maculopathy prior to cataract surgery, offering us high-yield findings beyond traditional retinal exams and color photos.
It was recently shown around 21.5% of eyes cleared for cataract surgery with normal retinal findings were found to have "sub-clinical" macular abnormalities detectable only through OCT. The most common include interface abnormalities (8.3%), drusen (4.1%), and diabetic macular edema (4.1%). Most importantly, in approximately 6.6% of cases hidden maculopathy could significantly alter expected visual outcomes, necessitating changes in surgical approach/planning or patient counseling. OCT's ability to detect subtle changes in retinal architecture allows for our early identification of pathology which may impact post-operative visual acuity or require additional interventions.
Factors such as advanced age and diabetes have been identified as significant predictors of sub-clinical maculopathy, suggesting these individuals may benefit most from preliminary OCT screening. Therefore, by including OCT into our preoperative protocol we can more comfortably set individual expectations, optimize surgical approaches, and potentially improve overall outcomes.
-JRM
Go to the article in Clinical Ophthalmology HERE.
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Doctor of Optometry & Natural Medicine
3 周Yes, and when the visual outcome is limited by maculopathy, we now have systems that can help restore retinal health and function. See RegenerateVision.com or contact me directly if you are in eye care.
Eye Doctor, Speaker, Past President OWNS, Passionate Advocate for the Power of Nutrition to Mitigate the Course of Disease and Promote Vitality, American Nutrition Association Board Member BCNS, Women in Opt Board
3 周Yes, always IMHO
Daily insights to grow medical optometry | Optometrist | Practice Owner Follow #2020habits for content
3 周That’s a high number! Essentially, 1/5 patients have undiagnosed macular abnormalities pre cataract sx. Adding that to the prevalence of OSD in that population should motivate primary care docs to create a pre-referral CE eval that essentially combines the macular eval (OCT-m) and OSD diagnostics.?