1
|
Wang J, Wang J, Chen D, Wu X, Xu Z, Yu X, Sheng S, Lin X, Chen X, Wu J, Ying H, Xu W. Prediction of postoperative visual acuity in patients with age-related cataracts using macular optical coherence tomography-based deep learning method. Front Med (Lausanne) 2023; 10:1165135. [PMID: 37250634 PMCID: PMC10213207 DOI: 10.3389/fmed.2023.1165135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/14/2023] [Indexed: 05/31/2023] Open
Abstract
Background To predict postoperative visual acuity (VA) in patients with age-related cataracts using macular optical coherence tomography-based deep learning method. Methods A total of 2,051 eyes from 2,051 patients with age-related cataracts were included. Preoperative optical coherence tomography (OCT) images and best-corrected visual acuity (BCVA) were collected. Five novel models (I, II, III, IV, and V) were proposed to predict postoperative BCVA. The dataset was randomly divided into a training (n = 1,231), validation (n = 410), and test set (n = 410). The performance of the models in predicting exact postoperative BCVA was evaluated using mean absolute error (MAE) and root mean square error (RMSE). The performance of the models in predicting whether postoperative BCVA was improved by at least two lines in the visual chart (0.2LogMAR) was evaluated using precision, sensitivity, accuracy, F1 and area under curve (AUC). Results Model V containing preoperative OCT images with horizontal and vertical B-scans, macular morphological feature indices, and preoperative BCVA had a better performance in predicting postoperative VA, with the lowest MAE (0.1250 and 0.1194LogMAR) and RMSE (0.2284 and 0.2362LogMAR), and the highest precision (90.7% and 91.7%), sensitivity (93.4% and 93.8%), accuracy (88% and 89%), F1 (92% and 92.7%) and AUCs (0.856 and 0.854) in the validation and test datasets, respectively. Conclusion The model had a good performance in predicting postoperative VA, when the input information contained preoperative OCT scans, macular morphological feature indices, and preoperative BCVA. The preoperative BCVA and macular OCT indices were of great significance in predicting postoperative VA in patients with age-related cataracts.
Collapse
Affiliation(s)
- Jingwen Wang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jinhong Wang
- College of Computer Science and Technology, Zhejiang University, Hangzhou, Zhejiang, China
| | - Dan Chen
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xingdi Wu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhe Xu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xuewen Yu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Ophthalmology, The First People’s Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Siting Sheng
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xueqi Lin
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiang Chen
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jian Wu
- Second Affiliated Hospital School of Medicine, School of Public Health, and Institute of Wenzhou, Zhejiang University, Hangzhou, Zhejiang, China
| | - Haochao Ying
- School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wen Xu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| |
Collapse
|
2
|
|
3
|
Macky TA, Mohamed AMH, Emarah AM, Osman AA, Gado AS. Predicting postoperative visual outcomes in cataract patients with maculopathy. Indian J Ophthalmol 2016; 63:775-8. [PMID: 26655002 PMCID: PMC4728976 DOI: 10.4103/0301-4738.171507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose: To assess the accuracy of the potential acuity meter (PAM) in predicting postcataract surgery visual acuity outcome in patients with healed inactive maculopathies. Study Design: Prospective interventional clinical trial. Patients and Methods: Patients scheduled for phacoemulsification had preoperative and 1 month postoperative best-corrected visual acuity (BCVA), PAM test, fluorescein angiography, and macular optical coherence tomography. Patients were grouped to following preoperative BCVA: PRE1: 0.29 and better, PRE2: 0.25–0.13, and PRE3: 0.1 or worse; age: G1 <60, G2 = 60–70, and G3 >70 years. PAM accuracy was divided into: Grade 1: Postoperative BCVA ≤1 or less line error of the PAM score, Grade 2: Between 1 and 2 lines error, and Grade 3: ≥3 lines or more error. Results: This study enrolled 57 patients with a mean age of 71.05 ± 6.78 years where 34 were females. There were 21 (36.84%) patients with diabetic maculopathy and 36 (63.16%) with age-related macular degeneration. The mean preoperative BCVA was 0.198 ± 0.12 (0.1–0.5). The mean PAM score was 0.442 ± 0.24 (0.1–1.3). The mean postoperative BCVA was 0.4352 ± 0.19 (0.17–1.00). The PAM score was in Grade 1, 2, and 3 in 46 (80.7%), 54 (94.7%), and 56 (98.2), respectively. There was a highly significant correlation between the PAM score and the postoperative BCVA (P < 0.001, Chi-square test). There was no correlation between the PAM test accuracy and age, gender, diagnosis, and preoperative BCVA (P = 0.661, 0.667, 0. 0.991, 0.833, Chi-square test; respectively). Conclusion: The PAM is an accurate method of predicting postoperative visual acuity for eyes with nuclear cataracts Grade I and II and inactive maculopathies.
Collapse
Affiliation(s)
- Tamer A Macky
- Department of Ophthalmology, Kasr El Aini Hospital, Cairo University, El-Manial, Cairo, Egypt
| | | | | | | | | |
Collapse
|
4
|
Vianya-Estopa M, Douthwaite WA, Funnell CL, Elliott DB. Clinician versus potential acuity test predictions of visual outcome after cataract surgery. ACTA ACUST UNITED AC 2009; 80:447-53. [PMID: 19635437 DOI: 10.1016/j.optm.2008.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Revised: 08/13/2008] [Accepted: 11/03/2008] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of this study was to compare the ability of potential vision tests and clinical judgement to predict postoperative visual acuity after uneventful cataract surgery. METHODS Sixty-two subjects (median, 74.5 years) were included in the study. Preoperative measurements included a clinical judgement prediction (based on case history and ocular examination alone), 2 super-illuminated pinhole techniques (distance and near), Potential Acuity Meter and interferometer. Postoperative visual acuity was used as the outcome measure to evaluate the accuracy of the preoperative predictions. RESULTS Subjects were categorized as follows: (a) moderate cataract (N = 25); (b) moderate cataract and comorbidity (N = 18), and (c) advanced cataract (N = 19). Preoperative predictions within 2 lines of the postoperative visual acuity were as follows (a, b, and c respectively): clinical judgement (92%, 72%, 58%), super-illuminated pinhole distance (96%, 100%, 21%), super-illuminated pinhole near (92%, 78%, 26%), Potential Acuity Meter (72%, 67%, 21%), and interferometer (56%, 61%, 37%). CONCLUSIONS Based on the preoperative predictions above, none of the potential vision tests was useful compared with the clinical judgement in the advanced cataract group. The super-illuminated pinhole (distance) provided additional information beyond clinical judgement in the moderate cataract subgroup. The Potential Acuity Meter and interferometer were inaccurate even in the presence of moderate cataract, and this and other recent findings suggest they should no longer be considered adequate for potential vision assessment.
Collapse
Affiliation(s)
- Marta Vianya-Estopa
- Department of Optometry, University of Bradford, Bradford, West Yorkshire, United Kingdom.
| | | | | | | |
Collapse
|
5
|
Bertschinger DR, Janin YA, Dosso A. Comparison of adapted Vryghem macular function test and Lotmar-light interferometer in predicting visual acuity after cataract surgery. Acta Ophthalmol 2008; 86:307-13. [PMID: 17995978 DOI: 10.1111/j.1600-0420.2007.01043.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess the accuracy of a newly described macular function test (Vryghem macular function test) adapted to our examination equipment and to compare it to the Lotmar-light interferometer for the preoperative evaluation of cataract patients at the University Eye Clinic, Geneva, Switzerland. METHODS This prospective study included 71 consecutive patients (72 eyes) who were undergoing uneventful cataract surgery. Testing with the Lotmar-light interferometer and an adapted form of Vryghem macular function test (AVMFT) using a Birkhauser reading chart, a hyperaddition of +8 D and halogen illumination were performed to assess macular function and to predict postoperative visual acuity (VA). The duration of each test and the density and location of lens opacities were also noted. Best-corrected postoperative VA was compared to the predicted values of each test. RESULTS The positive predictive value was 94.2% for AVMFT compared to 92.2% for the Lotmar-light interferometer. The negative predictive value was 50% for AVMFT compared to 42.9% for the Lotmar-light interferometer. The sensitivity was 83.1% for AVMFT and 79.7% for the Lotmar-light interferometer. The specificity was 76.9% for AVMFT and 69.2% for the Lotmar-light interferometer. The correlation coefficient for AVMFT and preoperative Lotmar results (both in LogMAR) with postoperative best-corrected VA (poBCVA; LogMAR) were similar (0.74 and 0.77 respectively). CONCLUSION The results of this study suggest that AVMFT is as reliable as the Lotmar-light interferometer in predicting postoperative VA after uneventful cataract surgery. The correlation coefficients with postoperative VA were 0.74 and 0.77, respectively. Both tests showed a high positive (94.2% and 92.2%, respectively) but a low negative (50.0% and 42.9%, respectively) predictive value.
Collapse
|
6
|
Douthwaite WA, Vianya-Estopà M, Elliott DB. Predictions of postoperative visual outcome in subjects with cataract: a preoperative and postoperative study. Br J Ophthalmol 2006; 91:638-43. [PMID: 17124240 PMCID: PMC1954778 DOI: 10.1136/bjo.2006.093401] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To assess the ability of critical flicker frequency (CFF) and optimal reading speed (ORS) to predict the potential vision in patients with cataract with and without ocular comorbidity. METHODS The two novel tests were compared with two well established potential vision tests (PVTs), the potential acuity meter (PAM) and the laser interferometer (LI). Measurements were made preoperatively in 1 eye of 88 subjects using the battery of 4 PVTs. Postoperative measurements were made with the CFF and the ORS. The subjects studied were consecutive cases over a 12-month period who fulfilled the inclusion and exclusion criteria, and agreed to participate in this study. RESULTS CFF was the PVT most resistant to the presence of cataract. Both CFF and ORS give a similar predictive precision in the presence of cataract and ocular comorbidity, although CFF seems more precise when the cataract is dense. CONCLUSIONS The PAM and the LI showed a limited clinical capability in predicting postoperative visual acuity, particularly with dense opacities. The CFF shows the most promise as a PVT, particularly with dense cataract. Further evaluation is required for both CFF and ORS.
Collapse
Affiliation(s)
- William A Douthwaite
- Department of Optometry, University of Bradford, Bradford, West Yorkshire BD7 1DP, UK.
| | | | | |
Collapse
|
7
|
Vianya-Estopà M, Douthwaite WA, Noble BA, Elliott DB. Capabilities of potential vision test measurements. J Cataract Refract Surg 2006; 32:1151-60. [PMID: 16857502 DOI: 10.1016/j.jcrs.2006.01.111] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2005] [Accepted: 01/29/2006] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the usefulness of a battery of potential vision tests (PVTs) including potential acuity meter (PAM), laser interferometer (LI), critical flicker/fusion frequency (CFF), superilluminated pinhole at distance (SPH(d)) and near (SPH(n)), and optimal reading speed (ORS) by their independence of the effects of cataracts and sensitivity to macular disease (MD). SETTING Department of Optometry, University of Bradford, Bradford and Leeds General Infirmary, Leeds, United Kingdom. METHODS Potential vision test measurements were determined in 76 patients with age-related cataract and no other eye disease, 52 patients with MD and clear ocular media, and 28 patients with normal, healthy eyes. RESULTS Potential vision tests were independent of the degrading effects of cataract up to a visual acuity (VA) level of 20/200 or worse (CFF), 20/125 (ORS and SPH), and 20/40 (PAM and LI). A high degree of association was found between PVT scores and distance VA in the MD group for SPH(d) (r2 = 0.93), SPH(n) (r2 = 0.89), and PAM (r2 = 0.71). A moderate correlation was found for LI (r2 = 0.55), CFF (r2 = 0.50), and ORS (r2 = 0.45). CONCLUSIONS Potential acuity meter and LI showed very limited independence to moderate/dense cataracts and inaccurate predictions in patients with MD. Superilluminated pinhole was relatively unaffected by moderate/dense cataract and yet provided accurate predictions in the presence of MD and clear ocular media. Critical flicker/fusion frequency showed the greatest ability to bypass cataracts, although its ability to predict VA in patients with early MD was limited. The ORS was relatively unaffected by moderate/dense cataract, but its poor ability to predict VA in MD may limit its clinical suitability as a PVT.
Collapse
Affiliation(s)
- Marta Vianya-Estopà
- Department of Optometry, University of Bradford, Bradford, West Yorkshire, United Kingdom
| | | | | | | |
Collapse
|
8
|
Reid O, Maberley DAL, Hollands H. Comparison of the potential acuity meter and the visometer in cataract patients. Eye (Lond) 2005; 21:195-9. [PMID: 16273082 DOI: 10.1038/sj.eye.6702165] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To compare the Guyton-Minkowski Potential Acuity Meter (PAM) and the Haag-Streit Lotmar Visometer (Visometer) in their ability to predict postoperative best corrected visual acuity (BCVA) in cataract surgery. SETTING University of British Columbia/Vancouver General Hospital Eye Care Center, Vancouver, British Columbia, Canada. METHODS In total, 292 eyes (223 patients) of subjects with cataracts and no known macular or optic nerve pathology were recruited over 6 months. Preoperative predictions of postoperative BCVA were compared with actual postoperative BCVA. The usefulness of these instruments as a 'diagnostic test' for predicting true surgical success (defined as postoperative BCVA of 20/40 or better) from predicted surgical success (PAM or Visometer predicted acuity 20/40 or better) was analysed. RESULTS Neither the PAM nor the Visometer predictions were statistically significant predictors of postoperative BCVA. The sensitivities of PAM and Visometer for predicting surgical success were 84.7% and 96.1%, respectively. The specificity of the PAM and Visometer for predicting surgical success was 27.3% and 9.1%, respectively. Overall, 92.7% of patients had 'successful surgery'. Given a predicted success from the PAM or Visometer the post-test probability of success was 93.5% and 93.1%, respectively. Given a predicted failure from the PAM or Visometer there was a post-test probability of surgical success of 87.5% and 84.6%, respectively. CONCLUSION We found no clinical benefit to support using the PAM or Visometer in the preoperative assessment of cataract patients with no known retinal or optic nerve pathology.
Collapse
Affiliation(s)
- O Reid
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | | |
Collapse
|
9
|
Chang MA, Airiani S, Miele D, Braunstein RE. A comparison of the potential acuity meter (PAM) and the illuminated near card (INC) in patients undergoing phacoemulsification. Eye (Lond) 2005; 20:1345-51. [PMID: 16179931 DOI: 10.1038/sj.eye.6702106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To compare the accuracy of the potential acuity meter (PAM) and the illuminated near card (INC) in patients undergoing phacoemulsification. METHODS During presurgical evaluations, both PAM and INC were tested on each study patient following dilation. Patients then rated the subjective ease of use of each test. Best spectacle-corrected visual acuity (BSCVA) was recorded at 4 and 12 weeks postoperatively. McNemar's chi(2) test for paired associations was used to analyse categorical data; paired t-tests were used for continuous variables. RESULTS Overall, the INC was more likely than the PAM to predict BSCVA within one Snellen line (P=0.002), but this difference decreased for accuracy within two lines. The PAM predicted BSCVA within one line in 87 (70.7%) eyes, as compared to 102 (82.9%) eyes by the INC. The PAM was accurate within two lines in 109 (88.6%) eyes; the INC was accurate in 115 (93.5%) eyes. The PAM was more likely to underpredict potential acuity (P<0.001), while the INC was more likely to overpredict (P=0.004) or give exact predictions of BSCVA (P<0.001). Accuracy of the INC declined in eyes with macular comorbidity. The PAM and INC were rated as 'easy' tests by 54 (45.4%) and 93 (78.2%) patients, respectively. CONCLUSIONS Both the PAM and the INC were useful for predicting BSCVA after phacoemulsification, but the PAM was more likely to underestimate potential acuity. The INC was easier for patients to use, and had better accuracy than the PAM in patients without macular comorbidity, but was more likely to overestimate potential acuity.
Collapse
Affiliation(s)
- M A Chang
- Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | | | | | | |
Collapse
|
10
|
Uy HS, Munoz VMR. Comparison of the potential acuity meter and pinhole tests in predicting postoperative visual acuity after cataract surgery. J Cataract Refract Surg 2005; 31:548-52. [PMID: 15811743 DOI: 10.1016/j.jcrs.2004.05.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2004] [Indexed: 10/25/2022]
Abstract
PURPOSE To compare the accuracy of potential acuity meter (PAM) and pinhole (PH) tests in predicting visual acuity after cataract surgery. SETTING Department of Ophthalmology and Visual Sciences, University of the Philippines, Philippine General Hospital, Manila, and Asian Eye Institute, Makati, Philippines. METHODS This prospective study comprised 64 eyes with mild to moderate cataract that had uneventful phacoemulsification. The PAM and PH tests were performed to predict postoperative visual acuity. Best corrected visual acuity (BCVA) 4 weeks after surgery was compared with the predicted visual acuity. The number of lines of inaccuracy was calculated by subtracting the BCVA from the predicted visual acuity. The variables analyzed were type of predictive test and preoperative BCVA. The eyes were divided according to preoperative BCVA as follows: Group 1, 20/20 to 20/50; Group 2, 20/60 to 20/100; Group 3, 20/200 or worse. RESULTS The PH predicted visual acuity was correct in 5% of eyes and the PAM predicted acuity, in 17%. The PH predicted acuity was accurate within 1, 2, and 3 lines of BCVA in 23%, 40%, and 54% of eyes, respectively, and the PAM predicted acuity, in 64%, 81%, and 92% of eyes, respectively. The mean number of lines of inaccuracy was significantly less with the PH than with the PAM (3.47 lines +/- 2.42 [SD] and 1.60 +/- 1.55 lines, respectively) (P=.0005). The mean lines of inaccuracy in Group 1 were 2.49 +/- 1.52 for the PH and 1.14 +/- 0.99 for the PAM (P=.027); in Group 2, 3.17 +/- 1.99 PH and 1.65 +/- 1.80 PAM (P=.642); and in Group 3, 6.58 +/- 3.03 PH and 2.67 +/- 2.10 PAM (P=.240). CONCLUSIONS The PAM was more accurate than the PH in predicting visual acuity after cataract surgery. The accuracy of both tests decreased in patients with poorer preoperative visual acuity.
Collapse
Affiliation(s)
- Harvey S Uy
- Asian Eye Institute, Makati City, Philippines
| | | |
Collapse
|
11
|
Quaid P, Stonier C, Cox MJ. Potential vision testing--the relationship between visual acuity and Vernier acuity in the presence of simulated cataract. Ophthalmic Physiol Opt 2002; 22:469-81. [PMID: 12477011 DOI: 10.1046/j.1475-1313.2002.00051.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To evaluate the utility of a computer controlled two-bar Vernier acuity measurement as a predictor of visual function in the presence of cataract we measured logMAR visual acuity and Vernier acuity in a group of 40 young normal observers under various levels of dioptric blur (0-3 D in dioptre steps). The Vernier thresholds were resistant to dioptric blur up to 2 D, but performance degraded with blur of 3 D for non-optimised Vernier stimulus parameters. The stimulus parameters, bar length and bar separation, were further investigated in two subjects under conditions of blur. By extending the Vernier bar length and increasing the bar separation the effect of blur could be further reduced even under the most blurred condition. The relationship between visual acuity and Vernier acuity was determined. Vernier acuity was measured in the presence of Vistech cataract simulating lenses and a prediction of visual acuity was made for three observers, two with no ocular abnormality and one with age-related maculopathy. The cataract simulating lenses affected the measured visual acuity in all three subjects, but had less effect on Vernier acuity. Predicted visual acuities were all within six letters (0.12 log units) of the visual acuity without the simulated cataract. As expected, the subject sufferng from age-related maculopathy, whilst showing similar levels of Vernier acuity to the two ocularly healthy subjects at 1.5 degrees of retinal eccentricity, showed much poorer Vernier acuity for stimuli presented at fixation.
Collapse
|
12
|
Hougaard JL, Wang M, Sander B, Larsen M. Effects of pseudophakic lens capsule opacification on optical coherence tomography of the macula. Curr Eye Res 2001; 23:415-21. [PMID: 12045891 DOI: 10.1076/ceyr.23.6.415.6966] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To report observations on the influence of posterior lens capsule opacification on optical coherence tomographic imaging quality and measurements of macular thickness. METHODS The retrospective study included 13 eyes in 12 patients of which 2 eyes had a healthy macula and 11 eyes had maculopathy. In all eyes posterior lens capsule fibrosis was present. A clinical examination including biomicroscopy of the macula and an in-vivo macular optical coherence tomography (OCT) before and after YAG-laser membranotomy had been performed. RESULTS Foveal retinal thickness before and after membranotomy were highly correlated (R = 0.98), and no systematic difference was found between values obtained before vs. after membranotomy (mean thickness 318.7 +/- 92.7 microm vs. 322.2 +/- 97.4 microm; p = 0.221). The signal-to-noise ratio increased in 11 out of 13 eyes after membranotomy (mean signal-to-noise ratio before 47.1 +/- 6.6 dB vs. 52.6 +/- 4.0 dB after; p = 0.004, the change ranging from -1.5 dB to 17 dB). CONCLUSIONS The qualitative effect of the posterior lens capsule opacification on the OCT-scan consists primarily of a loss of signal and consequently of intraretinal detail, whereas total foveal retinal thickness seems to be reliably assessed even when posterior lens capsule opacification interfering with the biomicroscopic evaluation of retinal edema are present. YAG-laser membranotomy results in a measurable improvement in the OCT signal-to-noise ratio, but OCT seems to yield reliable measurements of foveal retinal thickness before treatment. Consequently the OCT seems to reliably diagnose a macular thickening although not the type of this until after removal of the posterior lens capsule opacification.
Collapse
Affiliation(s)
- J L Hougaard
- Department of Ophthalmology, Herlev Hospital, University of Copenhagen, Denmark.
| | | | | | | |
Collapse
|