Newswise — 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.

About Dr. LeeDr. Thomas C. Lee, director of the Retina Institute in The Vision Center at Childrens 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 Spectral Domain Optical Coherence Tomography (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.

About The Vision Center – “Where all eye conditions receive extraordinary care.”

The Vision Center at Childrens Hospital Los Angeles is an international referral center known for its family friendly environment of children afflicted with all forms of eye disease and provides a full range of inpatient and outpatient services. It is the largest pediatric ophthalmology program in the nation with multiple subspecialty programs that are considered to be among today’s finest resources for diagnosis, treatment and research.

Founded in 1901, Childrens Hospital Los Angeles has been treating the most seriously ill and injured children in Los Angeles for more than a century, and it is acknowledged throughout the United States and around the world for its leadership in pediatric and adolescent health. Childrens Hospital is one of America’s premier teaching hospitals, affiliated with the Keck School of Medicine of the University of Southern California since 1932. The Saban Research Institute of Childrens Hospital Los Angeles is among the largest and most productive pediatric research facilities in the United States.

Since 1990, U.S. News & World Report and its panel of board-certified pediatricians have named Childrens Hospital Los Angeles one of the top pediatric facilities in the nation. Childrens Hospital Los Angeles is one of only 10 children’s hospitals in the nation – and the only children’s hospital on the West Coast – ranked in all 10 pediatric specialties in the U.S. News & World Report rankings and named to the magazine’s “Honor Roll” of children’s hospitals.

Childrens Hospital Los Angeles also is one of eight children’s hospitals in the nation to receive the “Top Hospital” designation from The Leapfrog Group. And Childrens Hospital Los Angeles is one of only three pediatric medical centers in the nation to receive both honors – “Top Hospital” from Leapfrog and the “Honor Roll” from U.S. News & World Report.

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Archives of Ophthalmology (Jan-2010)