Introduction: It has been reported that even using the swept-source optical coherence biometer, it is challenging to measure the axial length (AL) in cases with advanced cataracts. The enhanced retina visualization (ERV) mode, which is equipped with OCTB1 (ARGOS), shifts the peak of measurement sensitivity to the retina side so that the AL can be measured even if the light energy is attenuated. The aim of the present study was to evaluate the accuracy and efficacy of the ERV mode in measuring the AL of dense cataracts. Methods: This was a single-center retrospective observational case series conducted in Japan. We included 213 eyes of 213 consecutive patients with advanced cataracts who underwent preoperative evaluation. The AL was measured before and after surgery using two swept-source (SS) optical coherence tomography biometers (OCTB1, OCTB2; IOLMaster 700). Cases in which OCTB1 the standard mode failed to measure AL, OCTB1 with the ERV mode was used instead. Primary outcome measures were the acquisition rate and the AL measurement accuracy using the ERV mode. The Chi-square test, the Kruskal-Wallis test, and the Wilcoxon signed-rank test were used to compare the acquisition rate, differences between pre- and post-operative AL values, respectively. In the ERV subgroup, Bland-Altman plots were used to compare the pre- and post-operative AL values measured using OCTB1-ERV mode. A p-value of less than 5% was considered statistically significant. Results: The AL acquisition rate was not significantly different between OCTB1 with the standard mode and OCTB2. The AL of 65 eyes (30.5%) could not be measured using OCTB1 with the standard mode. Conversely, the AL of 51 of these eyes (78.5%) was successfully measured using OCTB1 with the ERV mode. In these 51 eyes, a difference of ≤0.2 mm and of ≤0.1 mm between pre- and post-operative AL measurements was observed in 40 (78.4%) and 30 eyes (58.8%), respectively. The Bland-Altman plot found no systematic error between pre- and post-operative AL values measured using the ERV mode. Conclusion: In patients with dense cataracts, AL measurement using the standard mode of an SS-OCT biometer is challenging. Furthermore, the ERV mode could be promising for AL measurement in such cases.


中文翻译：

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使用扫描源光学相干断层扫描生物仪的增强视网膜可视化模式评估致密性白内障的轴向长度测量

简介：据报道，即使使用扫频光学相干生物计，在晚期白内障病例中测量轴向长度 (AL) 也具有挑战性。搭载OCTB1（ARGOS）的增强视网膜可视化（ERV）模式将测量灵敏度的峰值转移到视网膜侧，即使光能衰减也可以测量AL。本研究的目的是评估 ERV 模式测量致密性白内障 AL 的准确性和有效性。方法：这是在日本进行的单中心回顾性观察病例系列。我们纳入了 213 名连续接受术前评估的晚期白内障患者的 213 只眼。使用两个扫描源 (SS) 光学相干断层扫描生物计 (OCTB1、OCTB2；IOLMaster 700)。在标准模式 OCTB1 无法测量 AL 的情况下，使用 ERV 模式的 OCTB1 代替。主要结果测量是使用 ERV 模式的采集率和 AL 测量精度。卡方检验、Kruskal-Wallis 检验和 Wilcoxon 符号秩检验分别用于比较采集率、术前和术后 AL 值之间的差异。在 ERV 亚组中，使用 Bland-Altman 图比较使用 OCTB1-ERV 模式测量的术前和术后 AL 值。小于 5% 的 p 值被认为具有统计学意义。结果：OCTB1 标准模式和OCTB2 的AL 采集率没有显着差异。使用标准模式的 OCTB1 无法测量 65 只眼 (30.5%) 的 AL。相反，其中 51 只眼睛的 AL（78. 5%) 使用带有 ERV 模式的 OCTB1 成功测量。在这 51 只眼中，分别在 40 只（78.4%）和 30 只眼（58.8%）中观察到术前和术后 AL 测量值之间的差异≤0.2 mm 和 ≤0.1 mm。Bland-Altman 图发现使用 ERV 模式测量的术前和术后 AL 值之间没有系统误差。结论：在致密性白内障患者中，使用标准模式的 SS-OCT 生物计测量 AL 具有挑战性。此外，在这种情况下，ERV 模式可能有望用于 AL 测量。Bland-Altman 图发现使用 ERV 模式测量的术前和术后 AL 值之间没有系统误差。结论：在致密性白内障患者中，使用标准模式的 SS-OCT 生物计测量 AL 具有挑战性。此外，在这种情况下，ERV 模式可能有望用于 AL 测量。Bland-Altman 图发现使用 ERV 模式测量的术前和术后 AL 值之间没有系统误差。结论：在致密性白内障患者中，使用标准模式的 SS-OCT 生物计测量 AL 具有挑战性。此外，在这种情况下，ERV 模式可能有望用于 AL 测量。