Prevalence and type of macular abnormality on optical coherence tomography in patient posted for cataract surgery from central India

Purpose: Prevalence of macular abnormality by optical coherence tomography (OCT) imaging in patients scheduled for cataract surgery. Methods: Retrospective, macular OCT analysis of patients who underwent cataract surgery with no apparent pathology detected on fundus examination was done. Subjects with mature white cataract, retinal pathologies on fundus examination, glaucoma, uveitis, previous intraocular surgery, corneal opacity, and poor quality OCT images with a signal strength of <40/100 were excluded from the study. Results: There were a total of 445 patients (491 eyes), with a mean age of 64.58 ± 8.91, the mean preoperative LogMAR visual acuity was 0.54 ± 0.14, and the mean preoperative central macular thickness was 247 ± 38. The most common abnormality noted on OCT was vitreomacular adhesion seen in 204, followed by epiretinal membrane in 74, foveal thining in 45, and vitreomacular traction in 30 eyes. Other abnormalities noted were loss of foveal contour, foveal atrophy, photoreceptor loss, ischemic retina, cystoid macular edema, lamellar macular hole, full-thickness macular hole, and myopic maculopathy. Abnormalities that may lead to suboptimal outcomes after cataract surgery were seen in 192 eyes. Additional interventions were done in 36 eyes. Intravitreal injection of triamcinolone acetonide was given in 19 eyes, and pars plana vitrectomy was done in 17 eyes. Conclusion: Macular pathology was 27.3% on spectral-domain-OCT before cataract surgery when no retinal pathology was detected on slit-lamp biomicroscopy. Every 27 th patient may harbor an undiagnosed macular abnormality if OCT-based screening is done before cataract surgery.