Abstract
Purpose :
Binocular indirect ophthalmoscopy (BIO), the current gold standard for retinopathy of prematurity (ROP) screening method, involves the use of an eyelid speculum and bright light. Handheld optical coherence tomography (OCT) is an imaging modality that is noncontact and may also identify ROP severity biomarkers. This prospective, observational study compared vital signs measured during BIO and OCT to determine if OCT has an advantage in lowering cardiorespiratory impact for premature infants at risk for ROP.
Methods :
Between 2019 and 2021,19 premature infants underwent both BIO and OCT examinations (using an investigational handheld swept source OCT) at least 30 minutes apart. Vital signs were measured at baseline, 1 and 2 minutes during, and 15 minutes after each examination. Data was excluded if possibly impacted by trainee examinations or RetCam photography. Paired comparisons of vital signs deviations from baseline were performed for each infant. The influence of ROP severity was examined.
Results :
There were 60 examinations for 19 infants (52.6% female, mean gestational age 28.8 ± 2.4 weeks, mean birth weight 1049.7 ± 263.3 grams). OCT took longer than BIO (12.76 vs. 4.55 minutes, P = 0.01). Vital signs change from baseline was greater for BIO than OCT at one minute (systolic blood pressure, BIO: +5.57 mmHg vs. OCT: -3.70 mmHg, 95% CI, -16.34 to -2.20, P = 0.01; diastolic blood pressure, BIO: +13.53 mmHg vs. OCT: +2.10 mmHg, 95% CI, -20.57 to -2.30, P = 0.02; heart rate: BIO: +16.8 bpm vs. OCT: -0.50 bpm, 95% CI, -28.5 to -6.1, P = 0.003) and 15 minutes (systolic blood pressure, BIO: +7.25 mmHg vs. OCT: -5.66 mmHg, 95% CI, -21.35 to -4.46, P = 0.004). At one minute, change in heart rate for BIO was lower for stage 3 ROP compared to stage 0, (-8.50 ± 17.68 bpm vs 27.93 ± 19.33 bpm; P = 0.01). At two minutes, change in oxygen saturation for BIO and OCT was greater for stage 2 compared to stage 0 ROP (BIO: +6.33% ± 7.51 vs. -1.43% ± 2.85, P = 0.01; OCT: +8.33% ± 6.03 vs. -.79% ± 2.83, P = 0.002).
Conclusions :
OCT was found to have a significantly lower impact on heart rate and blood pressure compared to BIO. Further research is needed to validate handheld OCT as an ROP screening tool. The ability to effectively screen and diagnose ROP using non-contact handheld OCT may benefit the overall health of premature infants.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.