The evaluation of assistant effect of intraoperative optical coherence tomography in vitreous retinal surgery for macular disease_Chinese Journal of Ocular Fundus Diseases

Authors：

Wang Qihua , Tao Jiwei , Lin Jingjing ,  Shen Lijun

Eye Hospital of Wenzhou Medical University, Hangzhou 310020, ChinaWang Qihua is working on the Department of Ophthalmology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghu University, Beijing 102218, China;

Corresponding author：

Shen Lijun, Email: 13868302929@139.com

Keywords：

Vitreoretinal surgery/instrumentation; Tomography, optical coherence; Macular disease

DOI：

10.3760/cma.j.issn.1005-1015.2019.01.012

Video：

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ObjectiveTo evaluate the assistant effect of intraoperative OCT (iOCT) in vitreous retinal surgery for macular disease.MethodsA retrospective case study. A total of 71 patients (71 eyes) with macular disease who underwent vitrectomy in Eye Hospital of Wenzhou Medical University at Hangzhou from June 2015 to September 2016 were collected. There were 24 males (24 eyes) and 47 females (47 eyes), aged from 25 to 78 years, with the mean age of 63.35±10.01 years. Among 71 eyes, there were 26 eyes with idiopathic macular hole, 42 eyes with idiopathic epiretinal membrane, 3 eyes with vitreomacular traction syndrome. The examination of iOCT was performed on the patients during 23G minimally invasive vitreoretinal surgery combined with internal limiting membrane peeling. Use observational method to compare the difference between result of iOCT and observation under the microscope, record the change of treatment strategy.ResultsEight eyes (11.27%) iOCT results were different from the surgeon’s observation, which including 5 eyes (62.50%) with idiopathic macular hole, 2 eyes (25.00%) with idiopathic epiretinal membrane, 1 eye (12.50%) with vitreomacular traction syndrome. The treatment strategy was changed in 8 eyes (11.27%) based on iOCT result, which including 5 eyes (62.50%) with idiopathic macular hole, 2 eyes (25.00%) with idiopathic epiretinal membrane, 1 eye (12.50%) with vitreomacular traction syndrome.ConclusionsiOCT can help the surgeon find some subtle morphological changes which can hardly be seen by eyes. The surgeon can change and optimize the treatment strategy based on the result of iOCT.

Citation： Wang Qihua, Tao Jiwei, Lin Jingjing, Shen Lijun. The evaluation of assistant effect of intraoperative optical coherence tomography in vitreous retinal surgery for macular disease. Chinese Journal of Ocular Fundus Diseases, 2019, 35(1): 54-57. doi: 10.3760/cma.j.issn.1005-1015.2019.01.012 Copy

1.	王奇骅, 陶继伟, 沈丽君. 手术中光相干断层扫描在玻璃体视网膜手术中的应用[J]. 中华眼底病杂志, 2015, 31(5): 498-500. DOI: 10.3760/cma.j.issn.1005-1015.2015.05.027.Wang QH, Tao JW, Shen LJ. The application of intraoperative optical coherence tomography in vitreous retinal surgery[J]. Chin J Ocul Fundus Dis, 2015, 31(5): 498-500. DOI: 10.3760/cma.j.issn.1005-1015.2015.05.027.
2.	陶继伟, 王奇骅, 褚梦琪, 等. 手术中光相干断层扫描在玻璃体视网膜手术中应用的初步观察报告[J]. 中华眼底病杂志, 2016, 32(5): 491-494. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.008.Tao JW, Wang QH, Chu MQ, et al. The preliminary application of intraoperative optical coherence tomography in vitreous retinal surgery[J]. Chin J Ocul Fundus Dis, 2016, 32(5): 491-494. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.008.
3.	Wykoff CC, Berrocal AM, Schefler AC, et al. Intraoperative OCT of a full-thickness macular hole before and after internal limiting membrane peeling[J]. Ophthalmic Surg Lasers Imaging, 2010, 41(1): 7-11. DOI: 10.3928/15428877-20091230-01.
4.	Ehlers JP, Griffith JF, Srivastava SK, et al. Intraoperative optical coherence tomography during vitreoretinal surgery for dense vitreous hemorrhage in the pioneer study[J]. Retina, 2015, 35(12): 2537-2542. DOI: 10.1097/IAE.0000000000000660.
5.	Pichi F, Alkabes M, Nucci P, et al. Intraoperative SD-OCT in macular surgery[J]. Ophthalmic Surg Lasers Imaging, 2012, 43(6 Suppl): S54-60. DOI: 10.3928/15428877-20121001-08.
6.	Falkner-Radler CI, Glittenberg C, Gabriel M, et al. Intrasurgical microscope-integrated spectral domain optical coherence tomography-assisted membrane peeling[J]. Retina, 2015, 35(10): 2100-2106. DOI: 10.1097/IAE.0000000000000596.
7.	Ehlers JP, Tam T, Kaiser PK, et al. Utility of intraoperative optical coherence tomography during vitrectomy surgery for vitreomacular traction syndrome[J]. Retina, 2014, 34(7): 1341-1346. DOI: 10.1097/IAE.0000000000000123.
8.	Hayashi A, Yagou T, Nakamura T, et al. Intraoperative changes in idiopathic macular holes by spectral-domain optical coherence tomography[J]. Case Rep Ophthalmol, 2011, 2(2): 149-154. DOI: 10.1159/000328752.
9.	Ehlers JP, Tao YK, Srivastava SK. The value of intraoperative optical coherence tomography imaging in vitreoretinal surgery[J]. Curr Opin Ophthalmol, 2014, 25(3): 221-227. DOI: 10.1097/ICU.000000000000044.
10.	Ehlers JP, Xu D, Kaiser PK, et al. Intrasurgical dynamics of macular hole surgery: an assessment of surgery-induced ultrastructural alterations with intraoperative optical coherence tomography[J]. Retina, 2014, 34(2): 213-221. DOI: 10.1097/IAE.0b013e318297daf3.
11.	Nam DH, Desouza PJ, Hahn P, et al. Intraoperative spectral-domain optical coherence tomography imaging after internal limiting membrane peeling in idiopathic epiretinal membrane with connecting strands[J]. Retina, 2015, 35(8): 1622-1630. DOI: 10.1097/IAE.000000000000534.
12.	Ray R, Barañano DE, Fortun JA, et al. Intraoperative microscope-mounted spectral domain optical coherence tomography for evaluation of retinal anatomy during macular surgery[J]. Ophthalmology, 2011, 118(11): 2212-2217. DOI: 10.1016/j.ophtha.2011.04.012.
13.	Ehlers JP, Yuan A, Kaiser PK. Trans-tamponade optical coherence tomography: postoperative imaging in gas-filled eyes[J]. Retina, 2013, 33(6): 1172-1178. DOI: 10.1097/IAE.0b013e31827b6565.
14.	Ehlers JP, Han J, Petkovesk D, et al. Membrane peeling-induced retinal alterations on intraoperative OCT in vitreomacular interface disorders from the PIONEER study[J]. Invest Ophthalmol Vis Sci, 2015, 56(12): 7324-7330. DOI: 10.1167/iovs.15-17526.
15.	Almeida DR, Wong J, Belliveau M, et al. Anatomical and visual outcomes of macular hole surgery with short-duration 3-day face-down positioning[J]. Retina, 2012, 32(3): 506-510. DOI: 10.1097/iae.0b013e3182219abd.
16.	Gupta D. Face-down posturing after macular hole surgery: a review[J]. Retina, 2009, 29(4): 430-443. DOI: 10.1097/IAE.0b013e3181a0bd01.
17.	Krohn J. Duration of face‐down positioning after macular hole surgery: a comparison between 1 week and 3 days[J]. Acta Ophthalmol Scand, 2005, 83(3): 289-292. DOI: 10.1111/j.1600-0420.2005.00462.x.
18.	Malik A, Dooley I, Mahmood U. Single night postoperative prone posturing in idiopathic macular hole surgery[J]. Eur J Ophthalmol, 2012, 22(3): 456-460. DOI: 10.5301/ejo.5000039.
19.	Dhawahir-Scala FE, Maino A, Saha K, et al. To posture or not to posture after macular hole surgery[J]. Retina, 2008, 28(1): 60-65. DOI: 10.1097/iae.0b013e31813c68a2.
20.	Yagi F, Sato Y, Takagi S, et al. Idiopathic macular hole vitrectomy without postoperative face-down positioning[J]. Jpn J Ophthalmol, 2009, 53(3): 215-218. DOI: 10.1007/s10384-008-0642-7.
21.	Tornambe PE, Poliner LS, Grote K. Macular hole surgery without face-down positioning: a pilot study[J]. Retina, 1997, 17(3): 179-185. DOI: 10.1097/00006982-199717030-00001.

1. 王奇骅, 陶继伟, 沈丽君. 手术中光相干断层扫描在玻璃体视网膜手术中的应用[J]. 中华眼底病杂志, 2015, 31(5): 498-500. DOI: 10.3760/cma.j.issn.1005-1015.2015.05.027.Wang QH, Tao JW, Shen LJ. The application of intraoperative optical coherence tomography in vitreous retinal surgery[J]. Chin J Ocul Fundus Dis, 2015, 31(5): 498-500. DOI: 10.3760/cma.j.issn.1005-1015.2015.05.027.
2. 陶继伟, 王奇骅, 褚梦琪, 等. 手术中光相干断层扫描在玻璃体视网膜手术中应用的初步观察报告[J]. 中华眼底病杂志, 2016, 32(5): 491-494. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.008.Tao JW, Wang QH, Chu MQ, et al. The preliminary application of intraoperative optical coherence tomography in vitreous retinal surgery[J]. Chin J Ocul Fundus Dis, 2016, 32(5): 491-494. DOI: 10.3760/cma.j.issn.1005-1015.2016.05.008.
3. Wykoff CC, Berrocal AM, Schefler AC, et al. Intraoperative OCT of a full-thickness macular hole before and after internal limiting membrane peeling[J]. Ophthalmic Surg Lasers Imaging, 2010, 41(1): 7-11. DOI: 10.3928/15428877-20091230-01.
4. Ehlers JP, Griffith JF, Srivastava SK, et al. Intraoperative optical coherence tomography during vitreoretinal surgery for dense vitreous hemorrhage in the pioneer study[J]. Retina, 2015, 35(12): 2537-2542. DOI: 10.1097/IAE.0000000000000660.
5. Pichi F, Alkabes M, Nucci P, et al. Intraoperative SD-OCT in macular surgery[J]. Ophthalmic Surg Lasers Imaging, 2012, 43(6 Suppl): S54-60. DOI: 10.3928/15428877-20121001-08.
6. Falkner-Radler CI, Glittenberg C, Gabriel M, et al. Intrasurgical microscope-integrated spectral domain optical coherence tomography-assisted membrane peeling[J]. Retina, 2015, 35(10): 2100-2106. DOI: 10.1097/IAE.0000000000000596.
7. Ehlers JP, Tam T, Kaiser PK, et al. Utility of intraoperative optical coherence tomography during vitrectomy surgery for vitreomacular traction syndrome[J]. Retina, 2014, 34(7): 1341-1346. DOI: 10.1097/IAE.0000000000000123.
8. Hayashi A, Yagou T, Nakamura T, et al. Intraoperative changes in idiopathic macular holes by spectral-domain optical coherence tomography[J]. Case Rep Ophthalmol, 2011, 2(2): 149-154. DOI: 10.1159/000328752.
9. Ehlers JP, Tao YK, Srivastava SK. The value of intraoperative optical coherence tomography imaging in vitreoretinal surgery[J]. Curr Opin Ophthalmol, 2014, 25(3): 221-227. DOI: 10.1097/ICU.000000000000044.
10. Ehlers JP, Xu D, Kaiser PK, et al. Intrasurgical dynamics of macular hole surgery: an assessment of surgery-induced ultrastructural alterations with intraoperative optical coherence tomography[J]. Retina, 2014, 34(2): 213-221. DOI: 10.1097/IAE.0b013e318297daf3.
11. Nam DH, Desouza PJ, Hahn P, et al. Intraoperative spectral-domain optical coherence tomography imaging after internal limiting membrane peeling in idiopathic epiretinal membrane with connecting strands[J]. Retina, 2015, 35(8): 1622-1630. DOI: 10.1097/IAE.000000000000534.
12. Ray R, Barañano DE, Fortun JA, et al. Intraoperative microscope-mounted spectral domain optical coherence tomography for evaluation of retinal anatomy during macular surgery[J]. Ophthalmology, 2011, 118(11): 2212-2217. DOI: 10.1016/j.ophtha.2011.04.012.
13. Ehlers JP, Yuan A, Kaiser PK. Trans-tamponade optical coherence tomography: postoperative imaging in gas-filled eyes[J]. Retina, 2013, 33(6): 1172-1178. DOI: 10.1097/IAE.0b013e31827b6565.
14. Ehlers JP, Han J, Petkovesk D, et al. Membrane peeling-induced retinal alterations on intraoperative OCT in vitreomacular interface disorders from the PIONEER study[J]. Invest Ophthalmol Vis Sci, 2015, 56(12): 7324-7330. DOI: 10.1167/iovs.15-17526.
15. Almeida DR, Wong J, Belliveau M, et al. Anatomical and visual outcomes of macular hole surgery with short-duration 3-day face-down positioning[J]. Retina, 2012, 32(3): 506-510. DOI: 10.1097/iae.0b013e3182219abd.
16. Gupta D. Face-down posturing after macular hole surgery: a review[J]. Retina, 2009, 29(4): 430-443. DOI: 10.1097/IAE.0b013e3181a0bd01.
17. Krohn J. Duration of face‐down positioning after macular hole surgery: a comparison between 1 week and 3 days[J]. Acta Ophthalmol Scand, 2005, 83(3): 289-292. DOI: 10.1111/j.1600-0420.2005.00462.x.
18. Malik A, Dooley I, Mahmood U. Single night postoperative prone posturing in idiopathic macular hole surgery[J]. Eur J Ophthalmol, 2012, 22(3): 456-460. DOI: 10.5301/ejo.5000039.
19. Dhawahir-Scala FE, Maino A, Saha K, et al. To posture or not to posture after macular hole surgery[J]. Retina, 2008, 28(1): 60-65. DOI: 10.1097/iae.0b013e31813c68a2.
20. Yagi F, Sato Y, Takagi S, et al. Idiopathic macular hole vitrectomy without postoperative face-down positioning[J]. Jpn J Ophthalmol, 2009, 53(3): 215-218. DOI: 10.1007/s10384-008-0642-7.
21. Tornambe PE, Poliner LS, Grote K. Macular hole surgery without face-down positioning: a pilot study[J]. Retina, 1997, 17(3): 179-185. DOI: 10.1097/00006982-199717030-00001.

Chinese Journal of Ocular Fundus Diseases

The evaluation of assistant effect of intraoperative optical coherence tomography in vitreous retinal surgery for macular disease

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