OSLI Retina

April 2020 Supplement

Issue link: http://osliretina.healio.com/i/1240026

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S50 Ophthalmic Surgery, Lasers & Imaging Retina | Healio.com/OSLIRetina ■ I N S T R U M E N T S / D E V I C E S / T E C H N O L O G Y ■ Comparison of Ocular Ultrasound Versus SD-OCT for Imaging of the Posterior Vitreous Status in Patients With DME Bernardete Pessoa, MD; João Coelho, MD; Luísa Malheiro, MD; Diana José, COT; Saúl Pires, COT; Constança Coelho, PhD; João Figueira, MD, PhD; Angelina Meireles, MD; João Melo-Beirão, MD, PhD BACKGROUND AND OBJECTIVES: To assess the per- centage of vitreous adherence to the posterior pole in patients with diabetic macular edema (DME) with ocular ultrasonography (US) and establish a comparison with spectral-domain optical coher- ence tomography (SD-OCT). PATIENTS AND METHODS: Cross-sectional consecu- tive analysis of patients followed in a diabetic reti- nopathy consultation. Vitrectomized eyes and pa- tients with epiretinal membranes were excluded. A comparison between macular SD-OCT 20 × 20º, SD-OCT 55 × 35º, and ocular US for the vitreous status was performed. A subanalysis of the percent- age of eyes with thickened posterior hyaloid and focal vitreous macular adhesion (VMA) was deter- mined with SD-OCT 20 × 20º and SD-OCT 55 × 35º. RESULTS: From 78 eyes of 39 patients, 55 eyes were included. All patients had type 2 diabetes mellitus with a median duration of 20 years (range: 3 to 40 years); 60% were phakic, and 61.8% were male. Previous treatments included intravitreal injections in 54.5% eyes, macular laser in 67.3%, and panreti- nal photocoagulation in 56.4%. All eyes had a non- posterior vitreous detachment (PVD) status on US. The 55 × 35º SD-OCT detected a non-PVD status in 96.4% (100% in video display mode) and a VMA in 87.3%. The 20 × 20º SD-OCT only detected a VMA in 43.6% of cases, with a thickened posterior hya- loid in 40% and a focal VMA in 18.2%. CONCLUSIONS: In the authors' DME patients, vit- reous adherence to the posterior pole was highly prevalent, with a total agreement between US and SD-OCT 55 × 35º video display mode. SD-OCT 20 × 20º is not an accurate method to diagnose VMA compared to SD-OCT 55 × 35º. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:S50-S53.] INTRODUCTION Vitreoschisis, anomalous or incomplete posterior vitreous detachment (PVD), is believed to be highly prevalent in diabetic patients and to play a role in the pathogenesis of diabetic macular edema (DME). 1-3 Although ocular ultrasonography (US) may be con- sidered the gold standard exam to establish the vitre- ous status, spectral-domain optical coherence tomog- raphy OCT (SD-OCT) is the retina imaging method most used worldwide. 4 Over the years, different technologies with dif- ferent threshold resolution capabilities to detect the multilamellar vitreous thickness may be re- sponsible for the differences reported concerning prevalence results. 5 The vitreous cortex may be erroneously assumed to be detached from the underneath macula when it is not visible in a current 20 × 20º SD-OCT acquisition. In this study the perception of vitreous adherence in the 20 × 20º central macular and 55 × 35º areas, including macula and optic disc, were evaluated with SD-OCT technology, establishing a comparison with ocular US. From Ophtalmology Department, Centro Hospitalar e Universitário do Porto, Portugal (BP, JC, LM, DJ, SP, AM,JMB); Instituto de Ciências Bio- médicas Abel Salazar, Universidade do Porto, Portugal (BP, AM, JMB); the Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal (JC); Genetics Laboratory, Institute of Environmental Health, Lisbon Medical School, University of Lisbon, Portugal (CC); Centro Hospitalar e Universitário de Coimbra, Faculty of Medicine of the Univer- sity of Coimbra, Portugal (JF); and Association for Innovation and Biomedi- cal Research on Light and Image, Coimbra, Portugal (JF). Originally submitted July 21, 2019. Revision received July 21, 2019. Accepted for publication September 10, 2019. Presented at the Retina World Congress 2019 meeting in Fort Lauderdale, Florida, March 21-24, 2019. The authors report no relevant financial disclosures. Address correspondence to Bernardete Pessoa, MD, Centro Hospitalar e Universitário do Porto – Hospital de Santo António, Departamento de Oftalmologia, Largo Prof. Abel Salazar, Edifício Neoclássico, 4099-001 Porto, Portugal; email: bbtpessoa@gmail.com. doi: 10.3928/23258160-20200401-07 TOP ABSTRACTS From RWC

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