Purpose of review To evaluate the part of intraoperative OCT (iOCT)

Purpose of review To evaluate the part of intraoperative OCT (iOCT) in vitreoretinal surgery assess the current state-of-the art and to examine possible future directions in the field. due to shadowing and light scattering properties. Summary The part of iOCT in vitreoretinal surgery continues to be defined by active research and enhancements to integrative systems. Further research is needed to better define the specific applications of iOCT that effect patient outcomes and medical decision-making. Future developments in integrative systems OCT-friendly instrumentation and software algorithms will further increase the horizon of iOCT in the vitreoretinal medical theatre. As OCT transformed the medical management of the vitreoretinal conditions iOCT has the potential to be a paradigm-shifting technology in the operating space. Keywords: OCT intraoperative OCT iOCT retina surgery vitreoretinal surgery Intro Vitreoretinal surgery offers undergone significant paradigm shifts over the last few decades that have advanced patient care and expanded our medical tool kit. Improvements to medical visualization have often resulted in incremental deviations from earlier standards in order to produce new anticipations for medical outcomes. Early examples of advances include the medical microscope and the subsequent foot-pedal control of translational microscope motion to allow for improved surgeon-control during methods.1-4 More recently wide-angle viewing systems enhanced illumination and small gauge surgery treatment have dramatically impacted the feasibility of various methods and improved surgical approaches to complex vitreoretinal diseases.5 In the clinical management of our individuals few recent development can compare to the effect that optical coherence tomography (OCT) offers played in analysis management and monitoring of vitreoretinal diseases. The introduction of anti-vascular endothelial growth factor (VEGF) medications and the subsequent tests using OCT-based management schemes have resulted in a significant paradigm shift Ophiopogonin D to OCT-assisted medical care.6 7 Not only has OCT been Ophiopogonin D critical for the management of VEGF-driven diseases (e.g. diabetic retinopathy age-related macular degeneration retinal venous occlusive disease) but in addition OCT has been instrumental Rabbit polyclonal to NFKB3. in optimizing the analysis and visualization of vitreoretinal interface disorders [e.g. macular opening (MH) Ophiopogonin D epiretinal membrane (ERM) vitreomacular traction (VMT)].8 In the same way that OCT offers transformed the clinical management of vitreoretinal conditions integration of OCT technology into the operating space theater may have significant effects in the surgical management of vitreoretinal conditions. This review shows the current state-of-the-art of intraoperative OCT (iOCT) including an examination of medical applications integrative OCT technology medical instrumentation and software algorithms. Clinical Applications Several vitreoretinal medical diseases have been explained with iOCT. These include macular opening epiretinal membrane retinal detachment vitreomacular traction as well as others. In these conditions iOCT has recognized significant architectural alterations that occur following medical manipulations. Macular opening Multiple studies possess examined iOCT during macular opening (MH) surgery. Imaging has been able to be performed both prior to and following internal limiting membrane (ILM) peeling during medical restoration.9-15 Significant alterations in Ophiopogonin D anatomy have been identified including variable changes in MH geometry and outer retinal alterations.9 10 12 14 15 Visualization of ILM curling on iOCT following successful peeling and focal areas of retinal elevation in the initiation sites for instrument-tissue interaction has been described.9 10 12 In the largest series to date MH volume and base area increased following ILM Peeling; while MH apex area decreased following ILM peeling.9 Outer retinal changes have been explained in multiple reports following surgical manipulation. In particular following ILM peeling growth of the distance between the retinal pigment epithelium (RPE) and the ellipsoid zone [i.e. inner segment/outer section (IS/OS) band] as well as improved lateral extension of this expansion have been recorded with iOCT.9 10 These architectural alterations have been examined in association with both functional and anatomical outcomes.9 In addition to baseline MH geometry alterations in the outer retina and MH configuration identified with iOCT were associated with final.