Imaging Device Diagnoses Neonates with Progressive Retinopathy of Prematurity More Effectively

Using a handheld spectral domain optical coherence tomography (SD-OCT) imaging device, researchers have obtained high-resolution retinal scans of premature infants with progressive retinopathy of prematurity (ROP).

Researchers reported in the January 2010 issue of the journal Archives of Ophthalmology that the new handheld devices eliminated many of the technical challenges involved in imaging the retina of infants and can enable shallow detachments and presumed retinoschisis to be diagnosed earlier and more accurately, significantly changing how physicians may classify and treat babies with this disease.

"The SD-OCT demonstrated presumed retinoschisis extending from the temporal ridge in three premature infants. This is a previously undescribed finding during the acute phases of advanced ROP. This advanced imaging can help surgeons determine a course of treatment that could make a difference in saving a child's sight,” said Dr. Thomas C. Lee, director of the Retina Institute, The Vision Center at Children's Hospital Los Angeles (CA, USA) and corresponding author of the article.

Despite the widespread use of OCT in the diagnosis and management of adult vitreoretinal diseases, its application to the pediatric population has been limited due to the technical challenges of working with this age group. The handheld SD-OCT system contains a moveable imaging hand piece that is connected via a 1.3-m flexible fiberoptic cable to a cart holding the SD-OCT system. This handheld system makes it possible to bring the advanced imaging capability into a neonatal intensive care unit (NICU).

ROP occurs when abnormal blood vessels grow and spread throughout the retina. These abnormal blood vessels scar the retina and pull it out of position, possibly leading to a retinal detachment. The handheld SD-OCT allows physicians to see stresses on the retina that are occurring before the actual detachment happens, and consequently intervene earlier and more aggressively.

According to the U.S. National Eye Institute, approximately 14,000 infants annually are affected by some degree of ROP, with 1,500 developing ROP severe enough to require treatment. About 400 to 600 become legally blind from ROP each year, making it one of the leading causes of blindness in children.

Dr. Thomas C. Lee, director of the Retina Institute in The Vision Center at Children's Hospital Los Angeles, has made significant advances in our understanding of pediatric retinal disorders. He has pioneered the use of cutting-edge imaging techniques such as SD-OCT to identify retinal detachments at the earliest possible stage. He is also the first to use an intraocular endoscope to perform complex surgery in pediatric retinal detachments resulting from retinopathy of prematurity, familial exudative vitreo-retinopathy, x-linked retinoschisis, and trauma.

The Vision Center at Children's Hospital Los Angeles is an international referral center and the largest pediatric ophthalmology program in the United States with multiple subspecialty programs that are considered to be among today's finest resources for diagnosis, treatment, and research.

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