AIM:To evaluate the clinical value of optical coherence tomography(OCT)in age-related cataract before phacoemulsification.METHODS:Four hundred cases 400 eyes of age-related cataract with normal fundus or only loss of foveal reflex under direct and indirect funduscopes were selected for study,including 100 cases with diabetic history,60 cases with high myopia.Besides traditional detailed ophthalmology examinations,all the subjects underwent macular exam with OCT before surgery.The omission diagnose rate of funduscopes and the risk ratio of general risk factors were calculated.RESULTS:Twenty-eight cases of maculopathy were found by OCT before cataract surgery,including 12 cases of macular edema,10 cases of age-related macular degeneration,2 cases of vitreomacular traction,1 case of macular hemorrhage,2 cases of macular hole and one case of macular atrophy.Diabetic history,high myopia and age above 60 years old were risk factors,and risk ratio with 95% confidence interval were 4(1.837,8.087),2.27(1.050,4.9),2.5(1.14,5.53)respectively.CONCLUSION:OCT is highly sensible in suspection of maculopathy before cataract surgery,especially for patients with diabetes,high myopia and old age,it can be recommended as preoperational routine examination.