Stellenwert der optischen Kohärenztomographie in der präoperativen Diagnostik funduskopisch unauffälliger Kataraktpatienten: Eine klinisch prospektive Studie.
The role of optical coherence tomography in patients prior to cataract surgery presenting with normal biomicroscopic funduscopy: A prospective study.
von Antonia Erdmann
Datum der mündl. Prüfung:2015-12-01
Betreuer:Prof. Dr. Hans Hoerauf
Gutachter:Prof. Dr. Hans Hoerauf
Gutachter:Prof. Dr. Christian O. Ritter
EnglischOptical coherence tomography (OCT) is a diagnostic method that allows for a detailed cross-sectional evaluation of the macular region. Macular examination as routinely performed by biomicroscopic funduscopy is one of the principal elements of preoperative cataract assessment. Due to media opacity occurring in patients with cataract, subtle macular pathologies may fail to be diagnosed using biomicroscopic funduscopy. OCT of the macular region might improve preoperative diagnostics in patients prior to cataract surgery. Accordingly the aim of the present study was to evaluate the additional diagnostic benefit of routine preoperative macular OCT in patients with cataract and normal biomicroscopic funduscopy. A total of 162 cataractous eyes of 123 patients who met the inclusion criteria were prospectively enrolled in the study. 78 eyes (48.15 %) showed no pathology on OCT-images. 72 eyes (44.44 %) presented changes at the vitreoretinal interface which were declared as regular age-related alterations. Macular abnormalities (e.g. epiretinal membrane or drusen) were detected by OCT in 20 eyes (12.35 %). Although this significant number of eyes showed macular abnormalities, none of the findings led to a change of therapy in any patient. All patients remained scheduled for cataract surgery without additive therapeutic intervention. Patients with pathological alterations observed on OCT-images were advised to make use of further follow-up examinations. In conclusion, OCT allows for a detailed evaluation of macular pathology in patients prior to cataract surgery presenting with normal biomicroscopic funduscopy. However, OCT-related observations did not lead to a modified therapeutic strategy and therefore should not generally be recommended to patients with normal biomicroscopic funduscopy prior to cataract surgery. Nevertheless, preoperative OCT-based detection of macular pathology impacts on further follow-up management.
Keywords: cataract; preoperative assessment; optical coherence tomography