OCT is a great test to see what the eye looks like, it  does not measure function.  You can't predict the surgical outcome with the OCT.  The RAM measures function only, the RAM result tells you if the vision loss is do to cataract or the macula.  It will inform you and  the patient what to realistically expect after cataract surgery.  The retina  can appear abnormal but has good function or the retina can look normal but has poor function . If the patient knows what to expect, that patient will be happy with less than a 20/20 outcome; if she expects 20/60 and gets 20/60, she will be happy.  If she expects 20/20 and gets 20/60, God help you.