Evaluation of Occult Macular Disease Before Cataract Surgery by Macular Spectral Domain-Optical Coherence Tomography
Mitra Akbari1 *
- Eye Research Center, School of Medicine, Guilan Univercity of Mrdical Science, Rasht, Iran
Abstract: The present study aimed to investigate the frequency of occult macular disease with Spectral Domain-Optical Coherence Tomography (SD-OCT) in candidates of cataract surgery with normal clinical examination.
Methods: Candidates of cataract surgery concluded 598 patients aged 15–90, who referred to Amiralmomenin Hospital, Rasht, Iran, from April 2018 until March 2020, were enrolled in the study. Corneal sub-specialist before surgery examined both eyes of all patients; the severity of cataract was graded based on Oxford Grading System; and if they had a normal retinal exam, macular OCT of both eyes was taken to evaluate any occult macular disease. The retinal sub-specialist reviewed all macular OCTs. Age, sex, history of hypertension (HTN), diabetes mellitus (DM), and smoking were obtained; systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured on the day before surgery. Fasting Blood Sugar (FBS) was checked one week before surgery.
Results: A total of 598 patients were evaluated; 5.52% of patients had occult macular lesions; Discovered pathologies were Epi-Retinal Membrane (ERM) (51.52%), Vitreomacular Traction (VMT) (27.27%), Acquired Vitelliform Lesion (AVL) (12.12%), full-thickness macular hole (6.06%), and lamellar macular hole (3.03%). Patients with occult macular lesions had a different frequency of age categories and hypertension and higher mean systolic and diastolic blood pressure (BP) (P<0.05). The frequency of cortical cataract was significantly less in patients without macular degeneration (P=0.012). Occult macular lesions were associated with hypertension (HTN) (P=0.023, OR=2.28), smoking (P=0.043, OR=3.43), and age>70 years (P=0.025, OR=11.12). The surgical plan only changed in 5 patients (0.83%).
Conclusion: Macular SD-OCT provides good information about macula before cataract surgery in terms of detecting occult macular lesions; but, because of little likelihood of changing the plan of surgery, it does not seem obligatory to perform this test for all patients.
