Detection of Latent Macular Lesions by Preoperative Optical Coherence Tomography and Associated Factors in Japanese Cataract Patients

Purpose: The purpose of this study was to determine the detection rate and associated factors of latent macular lesions using preoperative Spectral-domain optical coherence tomography (SD-OCT) in Japanese patients scheduled for cataract surgery with no clinically confirmed macular abnormalities. Setting: Teine Keijinkai Hospital, Sapporo, Japan. Design: Retrospective observational study Methods: We included 316 eyes of 316 Japanese cataract patients scheduled for surgery between January 2023 and December 2024 who had no suspected macular pathology on slit-lamp biomicroscopy. All patients underwent comprehensive ophthalmic examinations and SD-OCT, and the detection rate of latent macular lesions and their associated factors were investigated. Results: Latent macular lesions were detected in 30 eyes (9.5%) of 316 patients with a mean age of 76.8 ± 8.8 years. The most frequent lesions were epiretinal membrane (15 eyes, 4.7%), followed by irregular elevation of the retinal pigment epithelium (10 eyes, 3.2%). Clinically significant lesions requiring immediate surgical modification or additional treatment were identified in 3 eyes (1.0%), including a full-thickness macular hole (1 eye) and neovascular age-related macular degeneration (2 eyes). Age was independently associated with latent macular lesions (odds ratio 1.10, 95% Confidence Interval 1.04-1.16, P<0.01). Conclusion: Preoperative OCT screening may contribute to the evaluation of latent macular lesions, particulary in elderly cohort, and lead to optimized surgical planning.