New hand-held device eliminates technical challenges involved in imaging progressive ROP in infants

Using a hand-held 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), according to a report in this month's Archives of Ophthalmology.

Researchers reported the new hand-held 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 altering 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 Childrens Hospital Los Angeles 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 hand held SD-OCT system contains a moveable imaging hand piece that is connected via a 1.3-m flexible fiber optic cable to a cart holding the SD-OCT system. This handheld system makes it possible to bring the advanced imaging capability into a NICU (neonatal intensive care unit).

ROP occurs when abnormal blood vessels grow and spread throughout the retina, the tissue that lines the back of the eye. These abnormal blood vessels scar the retina and pull it out of position, possibly leading to a retinal detachment. The hand held 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 United States 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 400-600 become legally blind from ROP each year, making it one of the leading causes of blindness in children.