TY - JOUR
T1 - The Additive Value of Foveal OCT-Based Biometry to Fundus Biomicroscopy for Detecting Macular Pathology Prior to Cataract Surgery
AU - Rein, Adi Porat
AU - Abulafia, Adi
AU - Zadok, David
AU - Hanhart, Joel
AU - Gelman, Evgeny
AU - Weill, Yishay
N1 - Funding Information:
Funding/Support: This study received no funding. Financial Disclosures: Adi Abulafia is a consultant for Zeiss. The other authors indicate no financial support or conflicts of interest. All authors attest that they meet the current ICMJE criteria for authorship. Acknowledgments: We acknowledge the work of Yonathan Guttel for his statistical analysis assistance.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Purpose: To assess the additive value of foveal swept-source optical coherence tomography (OCT)–based biometry to the preoperative fundus examinations for diagnosing macular abnormalities in patients scheduled for cataract surgery. Design: Diagnostic testing evaluation. Methods: Consecutive patients 50 years of age and older planned for cataract surgery from one institution were retrospectively enrolled. All patients underwent foveal swept-source OCT, and macular spectral domain (SD) OCT scans before pupil dilation as well as dilated fundus biomicroscopy examination. The effectiveness of fundus biomicroscopy examinations, foveal swept-source OCT scans, and the combination of both in identifying macular diseases was analyzed with macular spectral-domain OCT scans as reference. Results: Seventy-eight of the eligible 442 eyes (442 patients) were excluded because of noninterpretable macular spectral-domain OCT OCT scans or foveal swept-source OCT scans. The remaining 364 eyes of 364 patients (mean age 73.59±9.26 years [range 49-96], 172 males) formed the study group. Fundus biomicroscopy alone vs fundus biomicroscopy with the addition of foveal swept-source OCT yielded 36% vs 63% sensitivity, 94% vs 72% specificity, 79% vs 58% positive predictive value (PPV), and 71% vs 76% negative predictive value (NPV), respectively. This diagnostic improvement was significant compared with fundus biomicroscopy alone (P = 2.98–8). Conclusion: Combined fundus biomicroscopy and foveal swept-source OCT scans improved the detection of macular abnormalities prior to cataract surgery but it was inferior to macular spectral-domain OCT scans. Additional studies to assess the cost-effectiveness of adding foveal swept-source OCT scan in comparison to macular spectral-domain OCT scan to the preoperative cataract evaluation are required.
AB - Purpose: To assess the additive value of foveal swept-source optical coherence tomography (OCT)–based biometry to the preoperative fundus examinations for diagnosing macular abnormalities in patients scheduled for cataract surgery. Design: Diagnostic testing evaluation. Methods: Consecutive patients 50 years of age and older planned for cataract surgery from one institution were retrospectively enrolled. All patients underwent foveal swept-source OCT, and macular spectral domain (SD) OCT scans before pupil dilation as well as dilated fundus biomicroscopy examination. The effectiveness of fundus biomicroscopy examinations, foveal swept-source OCT scans, and the combination of both in identifying macular diseases was analyzed with macular spectral-domain OCT scans as reference. Results: Seventy-eight of the eligible 442 eyes (442 patients) were excluded because of noninterpretable macular spectral-domain OCT OCT scans or foveal swept-source OCT scans. The remaining 364 eyes of 364 patients (mean age 73.59±9.26 years [range 49-96], 172 males) formed the study group. Fundus biomicroscopy alone vs fundus biomicroscopy with the addition of foveal swept-source OCT yielded 36% vs 63% sensitivity, 94% vs 72% specificity, 79% vs 58% positive predictive value (PPV), and 71% vs 76% negative predictive value (NPV), respectively. This diagnostic improvement was significant compared with fundus biomicroscopy alone (P = 2.98–8). Conclusion: Combined fundus biomicroscopy and foveal swept-source OCT scans improved the detection of macular abnormalities prior to cataract surgery but it was inferior to macular spectral-domain OCT scans. Additional studies to assess the cost-effectiveness of adding foveal swept-source OCT scan in comparison to macular spectral-domain OCT scan to the preoperative cataract evaluation are required.
UR - https://www.scopus.com/pages/publications/85105734918
U2 - 10.1016/j.ajo.2021.03.028
DO - 10.1016/j.ajo.2021.03.028
M3 - Article
C2 - 33826930
SN - 0002-9394
VL - 228
SP - 8
EP - 15
JO - American journal of ophthalmology
JF - American journal of ophthalmology
ER -