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

Abstract

• 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 chinrest 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.

Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

“…The use of the RetCam may cause some discomfort, with one suggestion that it contributed to RH in a neonate. 75 There have been reports of the value of optical coherence tomography (OCT) 76 in defining the layer of RH and possible role of the vitreous attachments in their causation. However, the universal use of the RetCam or OCT in all cases may be limited by practicalities and cost.…”

Retinal Morphologic Features in Shaken Baby Syndrome Evaluated by Optical Coherence Tomography

“…1 They document a sharp white-fold on color photograph of their first patient, and on time-domain OCT show deformation of the retina at a site of vitreous attachment to an epiretinal membrane (ERM) with small, round hyporeflective sites in the inner retina. We agree that vitreoretinal traction may play a key role in the pathologic characteristics of SBS; however, as…”

“…1 They presented a full-thickness macular hole (MH) with full-thickness retinal scarring and epiretinal membrane (ERM) formation as the sequelae of SBS.…”

Intraoperative optical coherence tomography: past, present, and future

“…[6][7][8][9]18 Although handheld imaging may provide excellent image quality, there are significant challenges that must be considered. Handheld imaging limits image reproducibility and optimal aiming.…”

“…[6][7][8][9][11][12][13][14][15][16][17][18][21][22][23]27,28,[32][33][34][35][36][37][38][39][40][41] The PIONEER study was a large prospective clinical study (n = 531) examining the role of intraoperative OCT with a microscope-mounted portable OCT system in ophthalmic surgery. 13 The DISCOVER study is a subsequent prospective clinical study (n = 227) examining microscope-integrated OCT in ophthalmic surgery.…”