Effect of Cataract Grade according to Wide-Field Fundus Images on Measurement of Macular Thickness in Cataract Patients

Abstract

PurposeTo investigate the effects of cataract grade based on wide-field fundus imaging on macular thickness measured by spectral domain optical coherence tomography (SD-OCT) and its signal-to-noise ratio (SNR).MethodsTwo hundred cataract patients (200 eyes) with preoperative measurements by wide-field fundus imaging and macular SD-OCT were enrolled. Cataract severity was graded from 1 to 4 according to the degree of macular obscuring by cataract artifact in fundus photo images. Cataract grade based on wide-field fundus image, the Lens Opacity Classification System III, macular thickness, and SD-OCT SNR were compared. All SD-OCT B-scan images were evaluated to detect errors in retinal layer segmentation.ResultsCataract grade based on wide-field fundus imaging was positively correlated with grade of posterior subcapsular cataracts (rho = 0.486, p < 0.001), but not with nuclear opalescence or cortical cataract using the Lens Opacity Classification System III. Cataract grade was negatively correlated with total macular thickness (rho = −0.509, p < 0.001) and SD-OCT SNR (rho = −0.568, p < 0.001). SD-OCT SNR was positively correlated with total macular thickness (rho = 0.571, p < 0.001). Of 200 eyes, 97 (48.5%) had segmentation errors on SD-OCT. As cataract grade increased and SD-OCT SNR decreased, the percentage of eyes with segmentation errors on SD-OCT increased. All measurements of macular thickness in eyes without segmentation errors were significantly greater than those of eyes with segmentation errors.ConclusionsPosterior subcapsular cataracts had profound effects on cataract grade based on wide-field fundus imaging. As cataract grade based on wide-field fundus image increased, macular thickness tended to be underestimated due to segmentation errors in SD-OCT images. Segmentation errors in SD-OCT should be considered when evaluating macular thickness in eyes with cataracts.

Comparison of multicolor scanning laser ophthalmoscopy and optical coherence tomography angiography for detection of microaneurysms in diabetic retinopathy

“…Third, this study included phakic and pseudophakic eyes. Intermediate opacities, including cataracts, are known to affect image quality to some extent 40 – 42 . Therefore, we excluded eyes with poor image quality owing to intermediate opacity, but the condition of the lens may have possibly affected the results.…”

“…Ocular examination was performed within 1 week. Eyes that received DME treatment within one month of the aforementioned examinations and eyes without clear images due to media opacities (such as cataract, which is known to affect the quality of fundus images 40 – 42 ) were excluded from analysis. FA and MC-SLO images were taken using a Spectralis HRA (Heidelberg Engineering, Heidelberg, Germany) with at least 30 averaged images for MC-SLO.…”

Early Phacoemulsification After Acute Angle Closure in Patients With Coexisting Cataract

“…2 In addition, exfoliative syndrome and glaucoma are strongly associated with clinically significant nuclear cataract, which considerably decreases image quality. 3,4 The authors do not provide any information on the number and distribution of pseudophakic eyes in the 2 groups; they do not report on cataract density; and they do not report on the image quality scores. Thus, it is possible that the minimally lower peripapillary vessel density values measured in the exfoliative glaucoma group in 3 locations are caused by the influence of greater lens opacity and the lower number of pseudophakic eyes on the image quality.…”

Early Phacoemulsification After Acute Angle Closure in Patients With Coexisting Cataract

“…As the preoperative and postoperative optic disc and visual field information is not known from the study, how did the authors divide the subgroups into PAC and PAC glaucoma. The optic disc, visual field, 2 and retinal nerve fiber layer thickness 3 show changes after APAC and if the patient has progressed to PAC glaucoma, combining phacoemulsification with trabeculectomy would have been more beneficial for the patient in terms of the intraocular pressure reduction and reducing the number of glaucoma medications. In Reply:…”