Enis D Kocak, Jonathan K Kam, Anthony J Hall, David van der Straaten

Purpose: Optical coherence tomography (OCT) is not routinely used for screening prior to cataract sur- gery in many centres. It has however been shown to be superior to dilated fundus examination along for detecting macular pathology. We performed a pro- spective, investigator-masked study to investigate the efficacy of OCT as compared to clinical examina- tion to detect macular pathology prior to routine cat- aract surgery.
Methods: Eyes of consecutive patients scheduled for cataract assessment clinic underwent macular OCT scanning after being examined by an ophthalmologist. Ophthalmologists were blinded to the OCT result unless they suspected pathology based on clinical examination. Pathology identified on OCT was addressed by a second clinician where necessary. Patients then underwent phacoemulsifica- tion cataract surgery where indicated. The primary outcome measure was the frequency of macular pathology on OCT versus clinical examination.
Results: 263 eyes were included in the study. Mac- ular pathology was identified on macular OCT in 27 patients (10.3%). In 13 of the 27 eyes with macu- lar pathology (51.8%), the pathology was not also detected clinically by dilated fundus examination.
Conclusion: Preoperative macular OCT detected macular pathology in 10% of cases, with the pathol- ogy evident on clinical examination in only half of these cases. This is similar to other previously reported series, and suggests routine preoperative scanning may be of benefit in high-volume centres.