Subfoveal fluid in healthy full-term newborns observed by handheld spectral domain optical coherence tomography

Abstract

Purpose-To report retinal findings for healthy newborn infants imaged with hand held Spectral Domain Optical Coherence Tomography (SD-OCT). Design-Prospective observational case series.Methods-Thirty-nine full term newborn infants had dilated retinal examinations by indirect ophthalmoscopy and retinal imaging by handheld SD-OCT, without sedation, at the Duke Birthing Center.Results-Of the 39 infants imaged, 44% (17/39) were male. Race/ethnicity composition was 56% white, 38% black, 3% Asian, and 3% Hispanic. Median gestational age was 39 weeks (range 36 to 41). Six of the 39 infants (15%) had bilateral subfoveal fluid on SD-OCT not seen by indirect ophthalmoscopy. Eight infants (21%) had retinal hemorrhages noted on dilated retinal examination, 1 of which had subretinal fluid on SD-OCT. Subretinal fluid was noted on follow up examination to have resolved on SD-OCT 1 to 4 months later. Infants with bilateral subretinal fluid had an older gestational age compared to infants without subretinal fluid (median 40.4 vs. 39.1 weeks, respectively, P=0.03) and were more likely to have had mothers with diabetes (2/6 vs. 0/33, respectively, P=0.02). Vaginal versus C-section delivery was not significantly different between the two groups.Conclusions-Some healthy full term infants have bilateral subfoveal fluid not obvious on dilated retinal examination. This fluid resolves within several months. The visual significance of this finding is unknown, but clinicians should be aware it is common when evaluating newborn infants for retinal pathology using SD-OCT.

Ganglion Cell Layer–Inner Plexiform Layer Thickness and Vision Loss in Young Children With Optic Pathway Gliomas

“…[31][32][33] The young age and inability of some subjects to complete automated perimetry limited our ability to establish distinct VF deficits with localized thinning of GCL-IPL. Lastly, while the number of studies using handheld SD-OCT in the pediatric population has been increasing, 24,[34][35][36][37][38][39][40] the ability of SD-OCT results to improve clinical care has not been firmly established. Therefore, additional research is needed before handheld SD-OCT results can used to make clinical decisions.…”

Amblyopia Preferred Practice Pattern®

“…12,13 Subtle or unrecognized abnormalities of the retina or optic nerve in amblyopic eyes may also contribute to vision loss. [14][15][16] In some cases, these conditions are associated with a refractive error that needs to be corrected.…”

Reproducibility of circumpapillary retinal nerve fiber layer measurements using handheld optical coherence tomography in sedated children

“…The development of a handheld SD-OCT has enabled pediatric practitioners to acquire high resolution images of the circumpapillary RNFL and macula in neonates, infants and young children. [13][14][15][16][17][18][19][20][21][22][23][24] While neonates and infants can be imaged while awake, the portability of the handheld OCT permits acquisition in toddlers and young children during sedation.…”