Feasibility to capture retinal microanatomy in novel handheld swept source optical coherence tomography imaging systems in non-sedated preterm infants in the intensive care nursery

Abstract

Purpose : To evaluate the feasibility to capture swept source optical coherence tomography (SSOCT) structural images of the fovea and optic nerve in non-sedated preterm infants in the intensive care nursery to distinguish elements of retinal microanatomy.

Methods : Preterm infants at risk for retinopathy of prematurity (ROP), who were enrolled under an institutional review board-approved study protocol, were imaged using one of two investigational ultra-compact handheld SSOCT 1060nm imaging systems developed with Duke Biomedical Engineers. Fovea and optic nerve structural imaging were attempted for all sessions. Images were scored as to whether they could be used to grade qualitative features and to measure segmented image layers for quantitative analysis. Study related adverse events (AEs) during imaging were also reviewed.

Results : 72 preterm infants were enrolled from 08/2016 to 12/2018. Bedside imaging from the earliest ROP exam during study enrollment through 41 weeks 6 days postmenstrual age (PMA) was pursued longitudinally at the time of each possible ROP examination for a total of 882 eye imaging sessions. Of these, 58 (7%) eye imaging sessions were deferred due to infant’s health and/or care team request. Of the remaining 824 (93%) attempted eye imaging sessions, fovea and optic nerve were successfully captured in 807 (98%) and 811 (98%) eye imaging sessions respectively. When the fovea and optic nerve were not captured, it was due to infant restlessness, or limited access to the eyes when imaged inside the incubator and/or on respiratory support, often at a younger age (median age 31 weeks and 35 weeks PMA respectively). 99.6% of foveal scans and 99.9% of optic nerve scans were acceptable for qualitative analysis. Segmentation for retinal thickness at fovea was feasible in 799 (99%) of the foveal scans. No study related AEs were encountered.

Conclusions : Handheld SSOCT imaging allows for fast and successful image acquisition in awake non-sedated infants at the time of ROP examinations. By distinguishing different elements of retinal microanatomy, these images will be used to provide insight into ROP disease processes and retinal development in preterm infants.

This is a 2020 ARVO Annual Meeting abstract.