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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