Handheld Swept-Source Optical Coherence Tomography Angiography in Awake Neonates Screened for Retinopathy of Prematurity

Abstract

Purpose : Retinopathy of prematurity (ROP) is a common cause of blindness in children. Swept-source optical coherence tomography angiography (SS-OCTA) is a noninvasive imaging modality demonstrating significant pathology in adult vascular proliferative disorders. We evaluated the efficacy of a novel handheld SS-OCTA prototype developed at the University of Washington.

Methods : Premature infants underwent SS-OCTA imaging with each routine ROP screening in the neonatal intensive care unit using an investigational handheld SS-OCTA (imaging speed 200 kHz). This device includes a mini-screen and pupil-finding live video on the probe for easier image acquisition. All imaging was performed without an eyelid speculum or sedation between June 1 and November 1, 2018 at the University of Washington Medical Center.

Results : Eight infants (3 females, median gestational age 27.3 [range, 26 to 35] weeks, median birth weight 895 [range, 455 to 1345] grams, stages 0 to 3 ROP) underwent a total of 19 eye imaging sessions and a median 1 (range, 1 to 6) imaging sessions per infant. Median postmenstrual age of the infants at imaging was 39 (range, 31 to 44) weeks. Good quality images of the foveal and peripapillary microvasculature were obtained in 11/19 (58%) eye imaging sessions for 6/8 (75%) infants and 14/19 (74%) eye imaging sessions for 5/8 (63%) infants, respectively. Each volume was acquired with approximately 30 degree field of view (6.3x6.3 mm) in 4.8 seconds. Each eye imaging session lasted maximum 7 minutes and 30 seconds.

Conclusions : Our noninvasive SS-OCTA prototype is capable of capturing good quality images of foveal and peripapillary microvasculature in premature infants screened for ROP. This is the first report showing successful OCTA imaging in awake, premature infants in the neonatal intensive care unit.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Examples of color-coded scan of swept-source optical coherence tomography angiography. Red indicates superficial retinal layer (SRL), Green indicates deep retinal layer (DRL) obtained by prototype handheld OCTA in awake neonates. (A) 6X6 mm scan of the left eye macula and optic nerve of a birth weight 1164 grams, gestational age 28 week infant at 43 weeks postmenstrual age (B) 6X6 mm scan of the left eye optic nerve of a birth weight 928 grams, gestational age 27 weeks infant at 36 weeks postmenstrual age with zone 3, stage 1 regressing, no plus disease retinopathy of prematurity.