BENEFIT OF INTRAOPERATIVE OPTICAL COHERENCE TOMOGRAPHY FOR VITREOMACULAR SURGERY IN HIGHLY MYOPIC EYES. Issue 10 (October 2018)

• Record Type: Journal Article
• Authors: Bruyère, Elsa; Philippakis, Elise; Dupas, Bénédicte; Nguyen-Kim, Pauline; Tadayoni, Ramin; Couturier, Aude
• Is Part Of: Retina. Volume 38:Issue 10(2018)
• Publication Date: 2018-10
• Subjects: high myopia -- intraoperative optical coherence tomography -- myopic foveoschisis -- myopic macular hole -- myopic traction maculopathy -- myopic vitreoretinal diseases -- vitreoretinal surgery; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000001827
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To report the feasibility and information provided by intraoperative optical coherence tomography (iOCT) during vitreomacular surgery in highly myopic eyes. Methods: Retrospective observational case series on consecutive highly myopic eyes that underwent vitreomacular surgery with iOCT for epiretinal membrane (ERM), macular hole, and myopic foveoschisis. The main outcome was the qualitative and quantitative assessment of retinal changes: detection of persistent epiretinal structures, new openings, central macular thickness, and macular hole diameters after each step of the surgical procedure. Quantitative measurements (in pixels) were manually obtained on iOCT video screen captures. Results: Twenty-two eyes were included: six ERMs, 10 macular holes, and 6 with myopic foveoschisis. An unsuspected postpeeling macular opening was detected by iOCT in 2/22 eyes. Intraoperative optical coherence tomography also allowed for detecting the presence of residual fragments of the vitreous cortex in 6/12 eyes after surgically induced posterior vitreous detachment. Intraoperative optical coherence tomography detected residual fragments of the internal limiting membrane in 5/21 eyes after internal limiting membrane peeling, and residual fragments of ERM in 3/15 eyes with ERM. Quantitative analysis did not find any significant change in central macular thickness and macular hole diameters before and after ERM and internal limiting membrane peeling. Conclusion: In highly myopic eyes, iOCT could help assess undetected macular openings and otherwise posterior vitreous status and epiretinal structure peeling. Abstract : In a series of 22 highly myopic eyes, intraoperative optical coherence tomography was able to detect the persistent vitreous cortex, residual epiretinal structures, and otherwise undetected macular openings. In the remaining cases, the peeling-induced acute traction did not significantly alter macular morphology.