Initial clinical experience with a novel high-speed ultra-compact handheld swept source optical coherence tomography imaging system to evaluate retinal microanatomy in adults, children and infants

Abstract

Purpose : To evaluate application of high-speed, handheld, ultra-compact, swept-source optical coherence tomography (SSOCT) imaging system on adults, children and infants in the intensive care nursery (ICN). We hypothesize that SSOCT imaging and processing will reveal distinct patterns of abnormalities in retinal structures responsible for sensory input along the visual pathway in preterm infants.

Methods : Under the Duke Institutional review board approved protocol, we obtained images using an investigational research SSOCT device developed by Duke Biomedical Engineers. This device utilized a 1050 nm swept-frequency laser, custom optics and mechanics, and a 2D microelectromechanical systems scanner, with a weight of 211g. Healthy adult volunteers (non-dilated pupils) and children undergoing examination under anesthesia (EUA) were imaged prior to bedside imaging in preterm infants. We attempted to capture fovea, optic nerve and temporal periphery at all imaging sessions.

Results : Four (8 eyes) healthy adult volunteers, 4 (8 eyes) children (15 months-8 years) undergoing EUA and 3 (6 eyes) preterm infants (28-31 weeks gestational age) were enrolled. We obtained multiple OCT volumes with an image acquisition time of one volume per second. We acquired good quality fovea and optic nerve scans from all participants. Microanatomy of retinoschisis and optic nerve hypoplasia, were identified on OCT during EUA. In the ICN, bedside imaging was conducted during multiple visits at the time of preterm infant’s examination for retinopathy of prematurity (ROP). We were able to follow and monitor the temporal periphery weekly as the ROP progressed from Stage 2 to 3. SSOCT imaging revealed vessel elevation, worsening severity of neovascular buds and complex at the vascular-avascular junction. With montage overlay, temporal retinal vascular development could be tracked.

Conclusions : A novel SSOCT device allows for faster image acquisition in infants and adults with and without pupil dilation. This innovation can simplify bedside imaging in infants and provide useful clinical correlation in preterm infants with ROP and revolutionize the management and prediction of future visual outcome in these infants.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

Swept Source Optical Coherence Tomography imaging on adult volunteer and images of the retina on a 40 week old infant.