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Christian Viehland, Xi Chen, Du Tran-viet, Shwetha Mangalesh, Ryan Imperio, Cynthia A Toth, Joseph A. Izatt; 400 kHz Handheld OCTA System for Bedside Imaging of Infant. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2906 – F0059.
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© ARVO (1962-2015); The Authors (2016-present)
We report on the development of a 400 kHz handheld optical coherence tomography angiography (HH-OCTA) system for imaging of young children and infants in the operating room and the intensive care nursery (ICN). The high speed of the 400 kHz engine allows for rapid capture of 9x9mm OCTA images (750 A-scans/B-scan, 750 B-scans/Volume, 4 repeats per B-scan location, total acquisition time of 7.5 seconds). Images are montaged to produce a composite OCTA image with a nasal temporal field of view comparable to a contact fundus camera.
We developed a 400 kHz OCT engine based on a VCSEL swept source laser (Thorlabs inc.) and used our previously reported HH-OCTA scanner that has an ergonomic grip optimized for supine imaging. Imaging was performed in 8 normal adult subjects in a supine position, 47 children/infants in clinic or during exams under anesthesia (EUAs) in the operating room, and 9 infants in the ICN. Retcam (Natus Medical, Pleasanton, CA) fluorescein angiography (FA) images were obtained during some EUAs for clinical care. OCTA images were generated in post processing using speckle variance and graph cut based segmentation was used to create projections of the vasculature. OCTA images were montaged in post processing. Optical power was set in accordance with the ANSI Z80.36 standard Light Hazard Protection for Ophthalmic Instruments and all human subjects research was performed under protocols approved by the Duke University institutional review board.
Representative HH-OCTA images from an infant undergoing exam under anesthesia are shown in fig. 1.
We demonstrated a 400 kHz HH-OCT system capable of capturing images at the infant bedside. These depth resolved OCTA images can show important pathological vascular features such as the extraretinal neovascular plaque and intraretinal vascular loops. When compared to a contact fundus camera fluorescein angiography the OCTA images provide superior, depth resolved visualization of the retinal microvasculature.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
Fig. 1: a) A montage of 7 HH-OCTA images acquired from a 5-month-old infant (born at 23 weeks gestational age) with zone 2 stage 4A ROP. Images cover a FOV of approximately 110x40°. The blue and red stars and lines denote the location of extraretinal neovascular plaque and intraretinal neovascular loops on (a-c) and B-scans shown in (b) b) OCTA B-scans with flow overlaid in color. c) Fluorescein angiography acquired as part of clinical care.
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