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A. M. Berrocal, S. K. Houston, Y. Pina, B. Bascom Palmer Imaging Group, T. G. Murray; Intraoperative Spectral Domain Optical Coherence Tomography (SD-OCT) Imaging of Complex Pediatric Retinal Disease. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3861.
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To describe the application of a unique intraoperative platform for obtaining Spectral Domain Optical Coherence Tomography (SD-OCT) and autofluorescence images in a series of pediatric patients with retinal disease.
A pilot series of 15 pediatric patients undergoing exam under anesthesia were evaluated with an intraoperative SD-OCT workstation. Following anesthesia administration, children underwent examination, including indirect biomicroscopy, wide-angle retinal imaging with RetCam-II, contact B-scan ultrasonography, and non-contact SD-OCT imaging with autofluorescence. OCT images were obtained using a Heidelberg SD-OCT with eye tracking laser technology. Images were correlated with clinical findings, retinal photographs, and ultrasound.
A consistent technique was determined to reliably obtain intraoperative SD-OCT imaging in pediatric patients with retinoblastoma, familial exudative vitreoretinopathy (FEVR), and normal retinal findings. 15 of 15 patients underwent successful imaging with the new SD-OCT technique. The workstation apparatus was stable, allowing for acquisition of high-resolution images of the macula as well as off-axis peripheral lesions. Additionally, autofluorescence imaging was performed for selected lesions. Despite potential effects on the optical media, images were able to be obtained before and after other imaging modalities without significant deterioration in image quality. Total SD-OCT imaging time was 5 minutes (range: 3 - 10).
This new platform for intraoperative SD-OCT with autofluorescence offers reliable imaging for pediatric patients with complex retinal diseases. SD-OCT imaging with eye tracking technology allows for progressive, consistent evaluation of specific retinal locations. Additionally, the technology allows for detection of autofluorescence, as well as the potential for other imaging modalities, including indocyanine green (ICG) and fluorescein angiograpy (FA). Intraoperative SD-OCT may become important for retinal diseases with macular involvement, as well as aiding in diagnosis and management of secondary complications. SD-OCT imaging may potentially be standard of care for intraoperative evaluation.
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