Is it possible to perform optical coherence tomography angiography in neonates with retinopathy of prematurity using a handheld device?
In this case series of 4 neonates with retinopathy of prematurity (3 in the neonatal intensive care unit and 1 under anesthesia in the operating room), handheld optical coherence tomography angiography was able to demonstrate retinal and choroidal vascular changes following laser treatment.
Handheld optical coherence tomography angiography was able to noninvasively visualize microvascular changes in retinopathy of prematurity, suggesting that future development and clinical validation of this technology in retinopathy of prematurity may be feasible.
Retinopathy of prematurity (ROP) is a leading cause of childhood blindness worldwide. Optical coherence tomography (OCT) has improved the care of adults with vitreoretinal disease, and OCT angiography (OCTA) is demonstrating promise as a technique to visualize the retinal vasculature with lower risk and cost than fluorescein angiography. However, to date, there are no commercially available devices able to obtain ultra–wide-field OCT or OCTA images in neonates.
To obtain ultra–wide-field OCT and OCTA images in neonates with ROP using a prototype handheld OCT and OCTA device.
Design, Setting, and Participants
This observational case series was conducted from March 1 to April 1, 2017, in an academic medical center among 4 neonates with ROP in the neonatal intensive care unit and in the operating room.
Main Outcomes and Measures
Acquisition of wide-field OCT and OCTA images using a handheld prototype OCTA and ultra–wide-field OCT device.
Images were obtained from 4 neonates (1 girl and 3 boys; mean age, 38 weeks’ postmenstrual age [range, 34-43 weeks]) with various stages of ROP: 3 in the neonatal intensive care unit and 1 in the operating room. The system can obtain noncontact en face OCT images and horizontal line scans with an approximately 40° field of view and up to 100° (ultra–wide-field) using a contact lens–based approach in a single 2-second scan. In addition, 20° × 20° (approximately 4 × 4-mm) OCTA scans were obtained in patients with ROP in a single 2-second scan.
Conclusions and Relevance
Optical coherence tomography and OCTA are gaining popularity in pediatric retinal imaging. This study reports on OCTA and ultra–wide-field OCT images in 4 neonates with various stages of ROP that were obtained using a prototype handheld device. Additional studies will be needed to prove the clinical value of this technology.
Campbell JP, Nudleman E, Yang J, et al. Handheld Optical Coherence Tomography Angiography and Ultra–Wide-Field Optical Coherence Tomography in Retinopathy of Prematurity. JAMA Ophthalmol. 2017;135(9):977–981. doi:10.1001/jamaophthalmol.2017.2481
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