Impact of optical coherence tomography on surgical decision making for epiretinal membranes and vitreomacular traction

Diana V Do, Minhee Cho, Quan Dong Nguyen, Syed Mahmood Shah, James T. Handa, Peter A. Campochiaro, Ingrid Zimmer-Galler, Jennifer U. Sung, Julia A. Haller

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

PURPOSE: To compare retina surgeons' recommendations for management of epiretinal membranes (ERM) and vitreomacular traction (VMT) based on clinical assessment alone with management based on clinical evaluation supplemented by optical coherence tomography (OCT). METHODS: A prospective, masked clinical case series was conducted. Surgeons first performed a complete history and physical examination on patients referred with the macular disorders under study without the benefit of adjunctive OCT, determined whether ERM, VMT, and/or macular edema were present, questionably present, or absent, and made a provisional management recommendation. The retina specialists then reviewed the OCT images for the presence or absence of ERM, VMT, and/or associated macular edema and reconsidered the final management recommendation in light of clinical evaluation combined with OCT findings. RESULTS: Eighty-four eyes of 73 patients were examined. ERM was identified in 66 (78.6%) of 84 eyes using clinical examination compared with 72 (85.7%) of 84 eyes using OCT (P = 0.06). VMT was identified in 5 (6%) of 84 eyes using clinical examination compared with 18 (21.4%) of 84 eyes using OCT (P < 0.005). Macular edema was identified in 57 (67.9%) of 84 eyes using clinical examination compared with 70 (83.3%) of 84 eyes using OCT (P = 0.003). Surgical intervention was recommended in 33 cases: 19 (57.6%) based on the history and clinical examination findings without OCT information and an additional 14 (42.4%) based on the combination of clinical evaluation and OCT findings. CONCLUSIONS: OCT is more sensitive than clinical examination in detecting ERM, VMT, and associated macular edema. Taken together with careful clinical evaluation, OCT findings influenced surgeons to recommend consideration of surgery to an additional 14 patients (42.2%) in this series.

Original languageEnglish (US)
Pages (from-to)552-556
Number of pages5
JournalRetina
Volume27
Issue number5
DOIs
StatePublished - Jun 1 2007

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Epiretinal Membrane
Optical Coherence Tomography
Traction
Decision Making
Macular Edema
Retina
History
Physical Examination

Keywords

  • Epiretinal membrane
  • Optical coherence tomography
  • Vitreomacular traction

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Do, D. V., Cho, M., Nguyen, Q. D., Shah, S. M., Handa, J. T., Campochiaro, P. A., ... Haller, J. A. (2007). Impact of optical coherence tomography on surgical decision making for epiretinal membranes and vitreomacular traction. Retina, 27(5), 552-556. https://doi.org/10.1097/IAE.0b013e31802c518b

Impact of optical coherence tomography on surgical decision making for epiretinal membranes and vitreomacular traction. / Do, Diana V; Cho, Minhee; Nguyen, Quan Dong; Shah, Syed Mahmood; Handa, James T.; Campochiaro, Peter A.; Zimmer-Galler, Ingrid; Sung, Jennifer U.; Haller, Julia A.

In: Retina, Vol. 27, No. 5, 01.06.2007, p. 552-556.

Research output: Contribution to journalArticle

Do, DV, Cho, M, Nguyen, QD, Shah, SM, Handa, JT, Campochiaro, PA, Zimmer-Galler, I, Sung, JU & Haller, JA 2007, 'Impact of optical coherence tomography on surgical decision making for epiretinal membranes and vitreomacular traction', Retina, vol. 27, no. 5, pp. 552-556. https://doi.org/10.1097/IAE.0b013e31802c518b
Do, Diana V ; Cho, Minhee ; Nguyen, Quan Dong ; Shah, Syed Mahmood ; Handa, James T. ; Campochiaro, Peter A. ; Zimmer-Galler, Ingrid ; Sung, Jennifer U. ; Haller, Julia A. / Impact of optical coherence tomography on surgical decision making for epiretinal membranes and vitreomacular traction. In: Retina. 2007 ; Vol. 27, No. 5. pp. 552-556.
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AU - Cho, Minhee

AU - Nguyen, Quan Dong

AU - Shah, Syed Mahmood

AU - Handa, James T.

AU - Campochiaro, Peter A.

AU - Zimmer-Galler, Ingrid

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N2 - PURPOSE: To compare retina surgeons' recommendations for management of epiretinal membranes (ERM) and vitreomacular traction (VMT) based on clinical assessment alone with management based on clinical evaluation supplemented by optical coherence tomography (OCT). METHODS: A prospective, masked clinical case series was conducted. Surgeons first performed a complete history and physical examination on patients referred with the macular disorders under study without the benefit of adjunctive OCT, determined whether ERM, VMT, and/or macular edema were present, questionably present, or absent, and made a provisional management recommendation. The retina specialists then reviewed the OCT images for the presence or absence of ERM, VMT, and/or associated macular edema and reconsidered the final management recommendation in light of clinical evaluation combined with OCT findings. RESULTS: Eighty-four eyes of 73 patients were examined. ERM was identified in 66 (78.6%) of 84 eyes using clinical examination compared with 72 (85.7%) of 84 eyes using OCT (P = 0.06). VMT was identified in 5 (6%) of 84 eyes using clinical examination compared with 18 (21.4%) of 84 eyes using OCT (P < 0.005). Macular edema was identified in 57 (67.9%) of 84 eyes using clinical examination compared with 70 (83.3%) of 84 eyes using OCT (P = 0.003). Surgical intervention was recommended in 33 cases: 19 (57.6%) based on the history and clinical examination findings without OCT information and an additional 14 (42.4%) based on the combination of clinical evaluation and OCT findings. CONCLUSIONS: OCT is more sensitive than clinical examination in detecting ERM, VMT, and associated macular edema. Taken together with careful clinical evaluation, OCT findings influenced surgeons to recommend consideration of surgery to an additional 14 patients (42.2%) in this series.

AB - PURPOSE: To compare retina surgeons' recommendations for management of epiretinal membranes (ERM) and vitreomacular traction (VMT) based on clinical assessment alone with management based on clinical evaluation supplemented by optical coherence tomography (OCT). METHODS: A prospective, masked clinical case series was conducted. Surgeons first performed a complete history and physical examination on patients referred with the macular disorders under study without the benefit of adjunctive OCT, determined whether ERM, VMT, and/or macular edema were present, questionably present, or absent, and made a provisional management recommendation. The retina specialists then reviewed the OCT images for the presence or absence of ERM, VMT, and/or associated macular edema and reconsidered the final management recommendation in light of clinical evaluation combined with OCT findings. RESULTS: Eighty-four eyes of 73 patients were examined. ERM was identified in 66 (78.6%) of 84 eyes using clinical examination compared with 72 (85.7%) of 84 eyes using OCT (P = 0.06). VMT was identified in 5 (6%) of 84 eyes using clinical examination compared with 18 (21.4%) of 84 eyes using OCT (P < 0.005). Macular edema was identified in 57 (67.9%) of 84 eyes using clinical examination compared with 70 (83.3%) of 84 eyes using OCT (P = 0.003). Surgical intervention was recommended in 33 cases: 19 (57.6%) based on the history and clinical examination findings without OCT information and an additional 14 (42.4%) based on the combination of clinical evaluation and OCT findings. CONCLUSIONS: OCT is more sensitive than clinical examination in detecting ERM, VMT, and associated macular edema. Taken together with careful clinical evaluation, OCT findings influenced surgeons to recommend consideration of surgery to an additional 14 patients (42.2%) in this series.

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