The preliminary application of intraoperative optical coherence tomography in vitreous retinal surgery_Chinese Journal of Ocular Fundus Diseases

Authors：

TaoJiwei , WangQihua , ChuMengqi , SuLingya , FangDong ,  ShenLijun

The Affiliated Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou 310020, China;

Corresponding author：

ShenLijun, Email: 13868302929@163.com

Keywords：

Vitreoretinal surgery/instrumentation; Tomography,optical coherence

DOI：

10.3760/cma.j.issn.1005-1015.2016.05.008

Video：

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Objective To observe the preliminary application of intraoperative optical coherence tomography (iOCT) in vitreous retinal surgery and the influencing factors of the imaging quality. Methods A retrospective case study. A total of 132 subjects were chosen in June 2015 and April 2016 in our hospital. All the subjects were taken vitreous retinal surgery and iOCT scanning. The patients included 46 males and 86 females, with an average age of 61.7 years. 111 cases had macular diseases and 21 cases had vitreous hemorrhage. Cases are divided into high myopia and non-high myopia group according to ocular axial length (AL), 28 eyes in high myopia group (AL≥26 mm),104 eyes in non-high myopia (AL<26 mm).The scanning time, image quality and eye conditions were observed during the operation. The discordance between surgeon microscope visualization of the pathology and the findings of the iOCT and the postoperative adverse reactions were also observed. Results The iOCT images were identified in 124 of 132 subjects, while were not identified in 8 eyes. For the macular area morphology change, iOCT tips and surgeon judgment rate was inconsistent in 22 eyes (16.7%). For the operation guidance value, change the operation rate of 12/132,accounted for 9.1%. The iOCT imaging quality of high myopia groups was lower than the non-high myopia groups (χ²=17.13, P=0.001). Corneal edema and operation time were considered as influencing factors on the quality of the imaging in the non-high myopia groups (r=3.75, 6.18; P=0.049, 0.013). There were no complications such as endophthalmitis. Conclusions The surgeon can observe morphological changes in the macular area through iOCT which is difficult to be observed by operating microscope and selected reasonable operation method during the surgery. High myopia, corneal edema and operation time affect the image quality.

Citation： TaoJiwei, WangQihua, ChuMengqi, SuLingya, FangDong, ShenLijun. The preliminary application of intraoperative optical coherence tomography in vitreous retinal surgery. Chinese Journal of Ocular Fundus Diseases, 2016, 32(5): 491-494. doi: 10.3760/cma.j.issn.1005-1015.2016.05.008 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.Application of intraoperative optical coherence tomography in vitrectomy[J].Chin J Ocul Fundus Dis,2015,31(5):498-500.DOI:10.3760/cma.j.issn.1005-1015.2015.05.027.
2.	Huang D, Swanson EA,Lin CP, et al. Optical coherence tomography[J].Science,1991,254(5035):1178-1181.
3.	Dayani PN, Maldonado R, Farsiu S,et al.Intraoperative use of handheld spectral domain optical coherence tomography imaging in macular surgery[J].Retina,2009,29(10):1457-1468. DOI:10.1097/IAE.0b013e3181b266bc.
4.	Tao YK, Ehlers JP, Toth CA, et al. Intraoperative spectral domain optical coherence tomography for vitreoretinal surgery[J]. Opt Lett,2010,35(20):3315-3317.DOI:10.1364/OL.35.003315.
5.	Ehlers JP, Tao YK, Farsiu S, et al. Visualization of real-time intraoperative maneuvers with a microscope-mounted spectral domain optical coherence tomography system[J].Retina,2013,33(1):232-236.DOI:10.1097/IAE.0b013e31826e86f5.
6.	Hahn P, Migacz J, O´Donnell R, et al. Preclinical evaluation and intraoperative human retinal imaging with a high-resolution microscope-integrated spectraldomain optical coherence tomography device[J].Retina,2013,33(7):1328-1337.DOI:10.1097/IAE.0b013e3182831293.
7.	Binder S, Falkner-Radler CI, Hauger C, et al. Feasibility of intrasurgical spectral-domain optical coherence tomography[J].Retina,2011,31(7):1332-1336.DOI:10.1097/IAE.0b013e3182019c18.
8.	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.
9.	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.
10.	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.
11.	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.
12.	Ehlers JP,Ohr MP, Kaiser PK,et al.Novel microarchitectural dynamics in rhegmatogenous retinal detachments identified with intraoperative optical coherence tomography[J].Retina,2013,33(7):1428-1434. DOI:10.1097/IAE.0b013e31828396b7.
13.	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.
14.	Lee LB, Srivastava SK.Intraoperative spectral-domain optical coherence tomography during complex retinal detachment repair.Ophthalmic Surg Lasers Imaging,2011,42:71-74. http://www.healio.com/doiresolver?doi=10.3928/15428877-201108044-05.DOI:10.3928/15428877-20110804-05.
15.	Leisser C, Hackl C, Hirnschall N,et al.Visualizing macular structures during membrane peeling surgery with an intraoperative Spectral-Domain optical coherence tomography device[J].Ophthalmic Surg Lasers Imaging Retina,2016,47(4):328-332. DOI:10.3928/23258160-20160324-04.
16.	Khan M, Ehlers JP.Clinical utility of intraoperative optical coherence tomography[J].Curr Opin Ophthalmol,2016,27(3):201-209. DOI:10.1097/ICU.0000000000000258.
17.	Ehlers JP.Intraoperative optical coherence tomography:past, present, and future[J].Eye (Lond),2016,30(2):193-201. DOI:10.1038/eye.2015.255/a>.
18.	Toygar O,Riemann CD.Intraoperative optical coherence tomography in macula involving rhegmatogenous retinal detachment repair with pars plana vitrectomy and perfluoron[J].Eye (Lond),2016,30(1):23-30. DOI:10.1038/eye.2015.230.
19.	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.
20.	Ehlers JP,Han J,Petkovsek 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.
21.	Smith AG, Cost BM, Ehlers JP.Intraoperative OCT-assisted subretinal perfluorocarbon liquid removal in the DISCOVER study[J].Ophthalmic Surg Lasers Imaging Retina,2015,46(9):964-966. DOI:10.3928/23258160-20151008-10.
22.	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.
23.	Mura M,Iannetta D,Nasini F,et al.Use of a new intra-ocular spectral domain optical coherence tomography in vitreoretinal surgery[J].Acta Ophthalmol,2016,94(3):246-252. DOI:10.1111/aos.12961.
24.	Pfau M, Michels S, Binder S. Clinical experience with the firstcommercially available intraoperative optical coherence tomography system[J].Ophthalmic Surg Lasers Imaging Retina,2015,46(10):1001-1008.DOI:10.3928/23258160-20151027-03.

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.Application of intraoperative optical coherence tomography in vitrectomy[J].Chin J Ocul Fundus Dis,2015,31(5):498-500.DOI:10.3760/cma.j.issn.1005-1015.2015.05.027.
2. Huang D, Swanson EA,Lin CP, et al. Optical coherence tomography[J].Science,1991,254(5035):1178-1181.
3. Dayani PN, Maldonado R, Farsiu S,et al.Intraoperative use of handheld spectral domain optical coherence tomography imaging in macular surgery[J].Retina,2009,29(10):1457-1468. DOI:10.1097/IAE.0b013e3181b266bc.
4. Tao YK, Ehlers JP, Toth CA, et al. Intraoperative spectral domain optical coherence tomography for vitreoretinal surgery[J]. Opt Lett,2010,35(20):3315-3317.DOI:10.1364/OL.35.003315.
5. Ehlers JP, Tao YK, Farsiu S, et al. Visualization of real-time intraoperative maneuvers with a microscope-mounted spectral domain optical coherence tomography system[J].Retina,2013,33(1):232-236.DOI:10.1097/IAE.0b013e31826e86f5.
6. Hahn P, Migacz J, O´Donnell R, et al. Preclinical evaluation and intraoperative human retinal imaging with a high-resolution microscope-integrated spectraldomain optical coherence tomography device[J].Retina,2013,33(7):1328-1337.DOI:10.1097/IAE.0b013e3182831293.
7. Binder S, Falkner-Radler CI, Hauger C, et al. Feasibility of intrasurgical spectral-domain optical coherence tomography[J].Retina,2011,31(7):1332-1336.DOI:10.1097/IAE.0b013e3182019c18.
8. 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.
9. 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.
10. 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.
11. 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.
12. Ehlers JP,Ohr MP, Kaiser PK,et al.Novel microarchitectural dynamics in rhegmatogenous retinal detachments identified with intraoperative optical coherence tomography[J].Retina,2013,33(7):1428-1434. DOI:10.1097/IAE.0b013e31828396b7.
13. 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.
14. Lee LB, Srivastava SK.Intraoperative spectral-domain optical coherence tomography during complex retinal detachment repair.Ophthalmic Surg Lasers Imaging,2011,42:71-74. http://www.healio.com/doiresolver?doi=10.3928/15428877-201108044-05.DOI:10.3928/15428877-20110804-05.
15. Leisser C, Hackl C, Hirnschall N,et al.Visualizing macular structures during membrane peeling surgery with an intraoperative Spectral-Domain optical coherence tomography device[J].Ophthalmic Surg Lasers Imaging Retina,2016,47(4):328-332. DOI:10.3928/23258160-20160324-04.
16. Khan M, Ehlers JP.Clinical utility of intraoperative optical coherence tomography[J].Curr Opin Ophthalmol,2016,27(3):201-209. DOI:10.1097/ICU.0000000000000258.
17. Ehlers JP.Intraoperative optical coherence tomography:past, present, and future[J].Eye (Lond),2016,30(2):193-201. DOI:10.1038/eye.2015.255/a>.

18. Toygar O,Riemann CD.Intraoperative optical coherence tomography in macula involving rhegmatogenous retinal detachment repair with pars plana vitrectomy and perfluoron[J].Eye (Lond),2016,30(1):23-30. DOI:10.1038/eye.2015.230.
19. 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.
20. Ehlers JP,Han J,Petkovsek 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.
21. Smith AG, Cost BM, Ehlers JP.Intraoperative OCT-assisted subretinal perfluorocarbon liquid removal in the DISCOVER study[J].Ophthalmic Surg Lasers Imaging Retina,2015,46(9):964-966. DOI:10.3928/23258160-20151008-10.
22. 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.
23. Mura M,Iannetta D,Nasini F,et al.Use of a new intra-ocular spectral domain optical coherence tomography in vitreoretinal surgery[J].Acta Ophthalmol,2016,94(3):246-252. DOI:10.1111/aos.12961.
24. Pfau M, Michels S, Binder S. Clinical experience with the firstcommercially available intraoperative optical coherence tomography system[J].Ophthalmic Surg Lasers Imaging Retina,2015,46(10):1001-1008.DOI:10.3928/23258160-20151027-03.

Chinese Journal of Ocular Fundus Diseases

The preliminary application of intraoperative optical coherence tomography in vitreous retinal surgery

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