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The reliability of OCT in detecting attached posterior vitreous before surgery for macular holes and epiretinal membranes

Session Details

Session Title: Imaging II

Session Date/Time: Friday 12/09/2014 | 16:30-18:00

Paper Time: 16:38

Venue: Boulevard C

First Author: : P.Aristodemou CYPRUS

Co Author(s): :    N. Kumar   S. Murjaneh   M. Brelen   M. Majid   R. Haynes   A. Dick

Abstract Details

Purpose:

To assess spectral domain optical coherence tomography (sd OCT) as a diagnostic tool in the pre-operative detection of attached posterior vitreous in macular pathologies and define diagnostic signs on OCT that can predict attached vitreous at surgery.

Setting:

The Vitreoretinal Service and The Academic Unit of Ophthalmology – University of Bristol, Bristol Eye Hospital, Bristol BS1 2LX, UK

Methods:

A double masked comparison of (1) OCT acquired on the day of surgery, analysed at a later date and recorded on a standardised form and (2) Surgical findings recorded on standardised form as a gold standard.

Results:

One hundred and three patients were recruited to the study, 67 had complete data and were included in the analysis. 37 had macular hole and 23 had epiretinal membrane (ERM) as the main pathology. Overall, sensitivity of OCT in detecting attached posterior vitreous was 80% and the specificity was 56%. For macular holes this was 91% and 60% respectively, whereas for epiretinal membranes it was 45% and 50%. The pattern of vitreous detachment in macular holes follows a predictable sequence of events, with the vitreous first detaching from the macula and then the disk. The vitreous signal is very clear and is mainly comprised from the posterior hyaloid face. The presence of the hyaloid face attaching to the disk is a reliable OCT sign for attached posterior vitreous. In ERM, attached vitreous can be in the form of posterior hyaloid face, vitreous strands or sometimes complete attachment which is not possible to differentiate from complete posterior vitreous detachment. No OCT diagnostic criteria for attached vitreous could be defined for ERM.

Conclusions:

OCT can reliably predict attached posterior vitreous in macular holes but not in epiretinal membranes

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