Imaging the Infant Retina with a Hand-held Spectral-Domain Optical Coherence Tomography Device

PURPOSE: To evaluate and treat infant retina through the use of a hand,held spectral-domain optical coherence tomography (SD OCT) device in selected cases of Shaken Baby syndrome (SBS). DESIGN: Observational case series. METHODS: A novel SD OCT system was optimized and evaluated for infant imaging. An adult eye was imaged with both a standard clinical SD OCT system and the hand-held system. Four eyes of two infants with a history of SBS were imaged with the hand-held system. One infant was imaged again during follow,up examinations. Robust image processing algorithms were developed to create high,quality images. Images were assessed for usefulness in demonstrating pertinent morphologic features. RESULTS: The novel SD OCT unit proved effective for data acquisition and comparable with conventional chin-rest SD OCT. Rapid data acquisition limited motion artifact within the B-scan, although there was slight motion between B scans. The SD OCT images provided previously unseen details with regard to the morphologic features of retinal lesions in these infant eyes. This information influenced prognosis and management. CONCLUSIONS: As with adults, the hand-held customized SD OCT proved to be an invaluable tool in the differentiation of disease processes or injury in these eyes under study. SD OCT imaging systems may be considered a useful adjunct to RetCam fundus photography for assessment and clinical management in cases of SBS. (Am J Ophthalmol 2009;147:364-373. (C) 2009 by Elsevier Inc. All rights reserved.)