Purpose: To assess the accuracy of swept-source optical coherence tomography (SS-OCT) in detecting complete posterior vitreous detachment (PVD) in comparison with intraoperative findings.
Methods: The retrospective study included 145 eyes of 145 consecutive patients who underwent surgery for epiretinal membranes or macular holes. Within a week prior to surgery, PVD status was evaluated by SS-OCT with a depth of field of 3 mm and a capture window of 16 × 8 mm. Complete PVD was identified when the hyaloid condensation was visible clearly on any B-scan or when the vitreous cortex reflectivity was not visible on all 33 B-scans. Sensitivity, specificity, positive predictive value, and negative predictive value of SS-OCT for detection of complete PVD were then compared with those evaluated during a triamcinolone acetonide-assisted vitrectomy.
Results: Of the 101 eyes diagnosed as complete PVD by SS-OCT preoperatively, 97 eyes were found to have complete PVD and four eyes were found to have attached vitreous intraoperatively. Of the 44 eyes categorized as attached vitreous by SS-OCT preoperatively, 43 eyes were graded as attached vitreous and one eye was graded as complete PVD during surgery. The sensitivity of SS-OCT for detecting complete PVD was 99.0% and the specificity was 91.5%. The positive predictive value and the negative predictive value were 96.0% and 97.7%, respectively.
Conclusions: Widefield (16 × 8 mm) SS-OCT showed high accuracy for the diagnosis of complete PVD in patients with epiretinal membranes or macular holes.
Translational relevance: Widefield SS-OCT has great potential to evaluate PVD status preoperatively and explore the mechanisms of vitreoretinal diseases.