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Occult Retinal Abnormalities Detected by Routine Optical Coherence Tomography in Comprehensive Eye Examination: A

Zoe Yau1, Rita W M Sum1, Andrew K C Lam1

  • 1School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, People's Republic of China.

Clinical Optometry
|June 15, 2026
PubMed
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This summary is machine-generated.

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Routine optical coherence tomography (OCT) screening detected common retinal abnormalities like posterior vitreous detachment and epiretinal membrane, often missed by dilated fundus examination. However, these findings may not significantly alter clinical management, questioning its necessity as a routine procedure.

Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Retinal Diagnostics

Background:

  • Optical coherence tomography (OCT) offers micron-level axial resolution, surpassing conventional dilated fundus examination (DFE) for detecting subtle retinal issues.
  • Integrating advanced imaging like OCT into routine eye care can potentially improve early detection of various ocular conditions.

Purpose of the Study:

  • To evaluate the effectiveness of routine OCT screening in identifying occult retinal abnormalities within a university clinical setting.
  • To compare the diagnostic yield of OCT against traditional DFE in a real-world clinical workflow.

Main Methods:

  • A retrospective analysis was performed on OCT images from 1398 patients aged 40+ undergoing comprehensive eye exams.
  • OCT imaging was conducted by an ophthalmic assistant prior to the optometrist consultation, using natural pupils.
Keywords:
comprehensive eye examinationdilated fundus examinationepiretinal membraneophthalmic imagingoptical coherence tomographyposterior vitreous detachment

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  • Electronic medical records were reviewed concurrently with OCT images for analysis.

    • Main Results:

    • Routine OCT identified several abnormalities not visible with DFE, including partial posterior vitreous detachment (5.9%), epiretinal membrane (3.4%), and peripapillary intrachoroidal cavitation (3.1%).
    • Other detected conditions included pigment epithelial detachment, thin retinal nerve fiber layer, focal choroidal excavation, and idiopathic central serous chorioretinopathy.
    • Older patients were more likely to have epiretinal membrane and lamellar holes, while males showed higher prevalence of focal choroidal excavation and idiopathic central serous chorioretinopathy.

    Conclusions:

    • OCT successfully identified occult retinal abnormalities undetectable by DFE.
    • However, many detected conditions were mild and unlikely to impact clinical management, suggesting routine OCT may not be essential.
    • Further research is needed to determine the clinical utility and cost-effectiveness of routine OCT screening.