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Sharel Ongchin, Dawn Sim, Rebecca Smith, Pearse Keane, Dhanes Thomas; Applications of Posterior Segment Optical Coherence Tomography (OCT) in Pediatric Ophthalmology. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3631.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the use of commercially available equipment for OCT imaging of pediatric patients in a large tertiary care facility.
This is a retrospective clinical study of 51 pediatric patients through a 12-month period who had OCT imaging performed at a Moorfields Eye Hospital, London, United Kingdom. Imaging was performed using 3D-TopCon or Heidelberg Spectralis imaging machines. No sedation was required to obtain imaging for any patient.
Posterior segment OCT images were obtained from 51 patients with mean age 11.9 years (age range 5 to 17) and 2.2 male to female ratio. Subjects were categorized into 3 groups: 1) inflammatory conditions (n=11), 2) inherited or congenital disease (CD) (n=33), and 3) others (n=7). Inflammatory conditions included anterior uveitis, intermediate uveitis, or patients with both. Inherited or congenital conditions included retinitis pigmentosa, rod-cone dystrophies, oculocutaneous albinism, choroideremia, X-linked retinoschisis, Stargardt’s disease, autosomal dominant optic atrophy, gyrate atrophy, Leber’s congenital amaurosis, and achromatopsia. Patients in the “others” category had decreased vision of unknown etiology, macular scars or lesions of unknown cause, Coat’s disease, or history of trauma with posterior segment pathology. As expected, the presence of cystoid macular edema (CME) was significantly different between groups, 6/11 (55%) in inflammatory conditions, 4/33 (12%) in inherited or congenital conditions, and 1/7 (14%) in others (Chi-square 9.03, p=0.01). OCT was used as an aid in diagnosis in 9/11 (82%), 13/33 (39%), 6/7 (86%) subjects respectively, and was significantly different between groups (Chi-square 9.11, p=0.01). The use of OCT for baseline documentation and monitoring was 3/11 (27%) in inflammatory conditions, compared to 27/33 (82%) in inherited conditions and 2/7 (29%) in others (Chi-square 14.5, p<0.001).
OCT imaging is becoming more commonly used in the pediatric population to assist with diagnosis, objective documentation, and treatment management. It is a non-invasive imaging modality that is well tolerated by children as young as 5 years of age. It is particularly useful in detecting macular edema in pediatric uveitis patients, as well as establishing baseline measurements in inherited retinal disease.
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