Feasibility of Theia T1-W widefield optical coherence tomography imaging in children

Abstract

Purpose : Handheld optical coherence tomography (OCT) has improved our understanding of pediatric retinal diseases, however, only one commercial handheld OCT system is available to date. Here we report and evaluate the first-in-human use of the investigational Theia widefield T1-W handheld OCT system in pediatric patients.

Methods : The widefield T1-W swept-source OCT system (Theia Imaging, LLC, Durham, NC) is an investigational handheld device that utilizes a 1060nm swept-source laser and has a scanning speed up to 500 frames/second and a field-of-view (FOV) of 145 degrees. Under IRB-approved protocols, pediatric participants were enrolled with parental consent and imaged either during examination under anesthesia (EUA) or in the pediatric retina clinic. OCT volumes optimized for high cross-sectional B-scan resolution or the en face image quality were captured. The FOV was visually evaluated by comparing the en face OCT images to standard-of-care widefield (Retcam) or ultra-widefield retinal images (Optos). The cross-sectional OCT B-scans were qualitatively evaluated by OCT grader.

Results : Thirteen eyes of 7 pediatric patients (age 8 months to 12 years old) were imaged with the T1-W handheld OCT system by 6 imagers. Eleven eyes of 6 patients were imaged during EUA, and 2 eyes of 1 patient were imaged in clinic. Widefield OCT images were successfully captured in all eyes. All imagers rated the OCT capture as “easy” or “very easy”. The T1-W OCT system captured the fovea, optic nerve, and mid-peripheral retina in a single OCT volume. The FOV was expanded by tilting the probe without manual manipulation of the globe (Figure 1). Cross-sectional B-scans showed good quality images of retinal layers in the macula.

Conclusions : Widefield pediatric retinal OCT imaging is feasible with the Theia T1-W handheld OCT system. Additional studies are under way to assess the reproducibility of this investigational device.

This abstract was presented at the 2024 ARVO Imaging in the Eye Conference, held in Seattle, WA, May 4, 2024.

 

Fig 1: The en face Theia T1-W widefield OCT image of the right eye of a 3-year-old boy (a) was compared to the standard-of-care widefield retinal image (b). The corresponding FOV was marked with a red dashed line (c). The en face images of the left eye of a 11-year-old boy (d) were compared with the ultra-widefield retinal image (e). Tilting the probe expanded the FOV (d). The cross-sectional B-scan through the fovea (dashed line in d) showed good quality images of retinal layers in the macula (f).