medwireNews: An investigational handheld ultra-widefield optical coherence tomography (UWF-OCT) device can provide high-quality images of the peripheral retina for use in diagnosing retinopathy of prematurity (ROP) without the need for scleral depression, study findings show.
“Our device is portable, is usable in awake neonates, and has very high axial resolution, enough to identify the difference in thickness between the retina and pars plana at the ora serrata,” say Benjamin Young (Oregon Health and Science University, Portland, USA) and colleagues in JAMA Ophthalmology.
They add that the device “may be associated with reduced technical challenges of capturing entire peripheral retina in telemedicine programs, may reduce pain and stress for delicate neonates owing to the reduced use of scleral depression, and, with adaptation of the system, could potentially allow for peripheral imaging of the whole retina in older children and adults.”
The UWF-OCT device has an imaging speed of 800 kHz and a 140° field of view and is placed on the ocular surface. It was used during a total of 507 ROP examinations in 83 neonates, who had a mean birthweight of 905.1 g and a mean gestational age of 189.5 days.
There were no adverse effects with use of the device and the edge of vascularization could be identified in all examinations, enabling detection of the ROP zone and stage, including to and beyond zone III. It took a median of 1 min 26 secs from the first to the last scan for examination of both eyes.
The team highlights that, in some cases, the orra serrata and ciliary body were “clearly identifiable in the en face OCT images obtained without scleral depression.” This included showing incomplete vascularization, features of the disease such as intraretinal neovascularization, and type I ROP after laser photocoagulation.
“This capability is the widest field imaging for neonates to our knowledge and may serve to improve clinicians’ and telemedicine services by eliminating the need for skilled scleral depression,” say the authors.
They concede that the device still requires direct contact with the cornea but point out that it uses infrared light instead of visible light, thereby “potentially causing less stress to neonates.”
The investigators acknowledge that the study involved a limited number of neonates and was conducted at a single clinical center by ROP-trained clinicians.
Nevertheless, Young and co-workers conclude that this UWF-OCT device “may facilitate imaging of the whole retina in awake neonates.”
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