PMID- 31667136 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220411 IS - 2223-4292 (Print) IS - 2223-4306 (Electronic) IS - 2223-4306 (Linking) VI - 9 IP - 9 DP - 2019 Sep TI - Handheld swept-source optical coherence tomography with angiography in awake premature neonates. PG - 1495-1502 LID - 10.21037/qims.2019.09.01 [doi] AB - BACKGROUND: Retinopathy of prematurity (ROP) can lead to retinal detachment and severe vision loss and is a common cause of childhood blindness. Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality that can be used to detect potential abnormalities in the microvasculature in this population. The objective of this study is to assess the feasibility of a newly developed handheld swept source OCT (SS-OCT) device to successfully acquire structural vitreoretinal and retinal microvascular images in awake premature infants. METHODS: OCT and OCTA images were acquired at the time of routine ROP examinations from awake, unsedated preterm infants in the Neonatal Intensive Care Unit using a clinical research prototype handheld probe integrated with an SS-OCT system working at 1,060 nm wavelength and an imaging speed of 200,000 A-scans per second (200 kHz), enabling volume OCT and OCTA scans. Each volume was acquired with approximately 36 field of view (~6.3x6.3 mm in infants) in 4.8 s. Quality of acquired OCT and OCTA volume images, microvascular information, and vitreoretinal features were determined by 3-masked grader consensus. RESULTS: Twelve infants (5 females, mean gestational age 28.3 weeks, median birth weight 901 g, stages 0 to 3 ROP) underwent a total of 73 individual eye imaging sessions. High-quality OCT images of the fovea and the optic nerve were present in 69/73 (94.5%) and 56/73 (76.7%) scans, respectively. Vitreous bands were observed in 10/73 (13.7%); punctate hyperreflective vitreous opacities in 47/73 (64.4%); epiretinal membrane (ERM) in 6/73 (8.2%); and cystoid macular edema (CME) in 12/73 (16.4%) scans. Mild vessel elevation was noted in 3/73 (4.1%) images, and severe vessel elevation in 4/73 (5.5%) scans. OCTA images obtained in 8 awake infants revealed good quality images of the foveal microvasculature in 11/19 (58%) eye imaging sessions for 6/8 (75%) infants; and peripapillary microvasculature in 14/19 (74%) eye imaging sessions for 5/8 (63%) infants. CONCLUSIONS: The SS-OCTA handheld device can capture important vitreoretinal characteristics such as peripapillary and foveal microvasculature, as well as hyperreflective punctate vitreous opacities and tractional vitreous bands, which may predict ROP severity. These images were captured in awake, premature infants without the use of direct ocular contact, an eyelid speculum, or sedation. CI - 2019 Quantitative Imaging in Medicine and Surgery. All rights reserved. FAU - Moshiri, Yasman AU - Moshiri Y AD - Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA. FAU - Legocki, Alex T AU - Legocki AT AD - Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA. FAU - Zhou, Kanheng AU - Zhou K AD - Department of Bioengineering, University of Washington, Seattle, WA 98195, USA. FAU - Cabrera, Michelle T AU - Cabrera MT AD - Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA. AD - Department of Ophthalmology, Seattle Children's Hospital, Seattle, WA 98105, USA. FAU - Rezaei, Kasra A AU - Rezaei KA AD - Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA. FAU - Tarczy-Hornoch, Kristina AU - Tarczy-Hornoch K AD - Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA. FAU - Wang, Ruikang K AU - Wang RK AD - Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA. AD - Department of Bioengineering, University of Washington, Seattle, WA 98195, USA. LA - eng PT - Journal Article PL - China TA - Quant Imaging Med Surg JT - Quantitative imaging in medicine and surgery JID - 101577942 PMC - PMC6785511 OTO - NOTNLM OT - Retinopathy of prematurity (ROP) OT - handheld probe OT - optical coherence tomography angiography (OCTA) OT - swept source optical coherence tomography COIS- Conflicts of Interest: Dr. Wang discloses intellectual property owned by the Oregon Health and Science University and the University of Washington. Dr. Wang also receives research support from Carl Zeiss Meditec Inc, Moptim Inc, Colgate Palmolive Company and Facebook Technology LLC. He is a consultant to Insight Photonic Solutions and Carl Zeiss Meditec. The other authors have no conflicts of interest to declare. EDAT- 2019/11/02 06:00 MHDA- 2019/11/02 06:01 PMCR- 2019/09/01 CRDT- 2019/11/01 06:00 PHST- 2019/11/01 06:00 [entrez] PHST- 2019/11/02 06:00 [pubmed] PHST- 2019/11/02 06:01 [medline] PHST- 2019/09/01 00:00 [pmc-release] AID - qims-09-09-1495 [pii] AID - 10.21037/qims.2019.09.01 [doi] PST - ppublish SO - Quant Imaging Med Surg. 2019 Sep;9(9):1495-1502. doi: 10.21037/qims.2019.09.01.