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Du Tran-Viet, Ramiro Maldonado, Eric Yuan, Amy Tong, Cynthia Toth; Handheld Spectral Domain Optical Coherence Tomography Imaging in Undilated Preterm Infants in the NICU. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2325.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the feasibility and image quality of Spectral Domain Optical Coherence Tomography (SDOCT) imaging on undilated, nonsedated preterm infants when compared to SDOCT images of dilated preterm infants of the same age who underwent screening for retinopathy of prematurity.
SDOCT images and pupil size measurements were obtained in both eyes of 3 undilated preterm infants and 3 pharmacologically dilated preterm infants using an 840nm wavelength portable SDOCT system (Bioptigen Inc., Research Triangle Park, NC) at the Duke Neonatal Intensive Care Unit. The preterm infants were age-matched at 37 weeks postmenstrual age (PMA), 39 weeks PMA, and 42 weeks PMA. The highest quality SDOCT images at the fovea and optic nerve in both eyes were selected for analysis. Feasibility was assessed based on successful capture of the fovea and optic nerve. Image quality was evaluated at the fovea based on the ability to distinguish retinal layer boundaries. The quality of en-face retinal image (EFRI) generated from the SDOCT was also assessed by evaluating the presence of image clipping and motion artifacts.
The pupil size ranged from 2.0-2.5mm in the undilated eyes versus 7mm in the dilated eyes. The fovea was visualized in 12/12 eyes regardless of pupil dilation. Optic nerve was visualized in 5/6 (83%) undilated eyes versus 6/6 (100%) dilated eyes. Retinal layer boundaries were distinguishable in 12/12 eyes regardless of pupil dilation. On the EFRI, motion artifact was present in 3/6 (50%) undilated eyes versus 3/6 (50%) dilated eyes. Clipping was present in 4/6 (67%) undilated eyes versus 2/6 (33%) dilated eyes.
This analysis revealed that capturing SDOCT images at the fovea and optic nerve was possible even when imaging with a small, undilated pupil on preterm infants. Furthermore, SDOCT image quality of undilated preterm infants was comparable to that of dilated preterm infants at the same age based on distinguishable retinal layer boundaries. By utilizing this imaging methodology, one can reduce infant discomfort and risks related to dilation drops, while preserving comparable results to that of dilated infants.
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