Journal
RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES
Volume 38, Issue 8, Pages 1588-1594Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/IAE.0000000000001735
Keywords
brain injury; hie; hypoxic injury; hypoxic ischemic encephalopathy; imaging; infants; OCT; optical coherence tomography; preterm infants; pupil; retina; retinopathy of prematurity; sdoct; undilated
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Funding
- NIH [1UL1RR024128]
- NIH Roadmap for Medical Research [1UL1TR001117]
- National Center for Advancing Translational Sciences [R01 EY025009]
- Center Core Grant for Vision Research [P30 EY005722]
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Purpose: The authors investigated feasibility of undilated handheld spectral domain optical coherence tomography (SDOCT) retinal imaging in preterm infants and children with neurologic abnormalities. Methods: Under an institutional review board-approved protocol, the authors attempted handheld SDOCT imaging of the retina, choroid, and optic nerve in infants and young children without pupil dilation. Scans were analyzed for quality and successful capture of foveal, optic nerve, and retinal structural parameters and abnormalities. Results: The authors obtained images through an undilated pupil of 11 infants/children over 28 eye imaging sessions, 27 at the bedside without sedation, and one under anesthesia. Infants had retinopathy of prematurity (n = 8), hypoxic ischemic encephalopathy (n = 2), or obstructive hydrocephalus (n = 1 child). Pupil sizes ranged from 1.0 mm to 3.5 mm. The authors captured fovea and optic nerve scans in 25/28 eye imaging sessions, with scans of adequate quality to discern prespecified foveal and optic nerve morphology, and of the 25 sessions, the choroidal-scleral junction was visible in all but 6 sessions. Conclusion: Undilated, handheld SDOCT imaging is a potential alternative method to evaluate the retina and optic nerve in patients with relative contraindication to pharmacological pupil dilation. This approach will enable the study of the eye-brain connection and ocular manifestations of neurologic diseases.
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