Siebelmann S, Bachmann B, Lappas A, Dietlein T, Steven P, Cursiefen C
Zentrum für Augenheilkunde, Uniklinik Köln, Kerpener Str. 62, 50924, Köln, Deutschland.
Cluster of Excellence: Cellular Stress Responses in Aging-associated Diseases (CECAD), University of Cologne, Köln, Deutschland.
Ophthalmologe. 2016 Aug;113(8):651-5. doi: 10.1007/s00347-016-0299-4.
Examination of newborn and children under general anesthesia is essential to prevent amblyopia and blindness; however, the validity was often limited due to a lack of state of the art diagnostic tools in the intraoperative set-up, e. g. optical coherence tomography (OCT). Since OCT devices have been integrated into surgical microscopes, this technique is also available for examination with patients under general anesthesia.
To give an overview about the possibilities of intraoperative OCT (iOCT) during examination of newborn and infant children under general anesthesia.
Analysis of recent literature (PubMed) and initial experiences at the Center for Ophthalmology of the University Hospital of Cologne.
The use of iOCT enables real-time high-resolution imaging during examinations of children under general anesthesia. All relevant structures of the anterior eye segment (including cornea, lens, chamber angle and iris) can be visualized. Especially when the anterior chamber view is limited due to corneal opacifications, iOCT can deliver important information in addition to that obtained using a surgical microscope. This information is important for the further therapy of the patients.
Online iOCT is a useful extension of the normal surgical microscope, especially for examination of children under general anesthesia and limited view into the anterior chamber. In our experience it also makes sense to transfer this technique to anomalies of the posterior pole because high-resolution imaging of the macula and optic nerve head is possible.
在全身麻醉下对新生儿和儿童进行检查对于预防弱视和失明至关重要；然而，由于术中设置缺乏先进的诊断工具，例如光学相干断层扫描（OCT），其有效性常常受到限制。自从OCT设备被集成到手术显微镜中，这项技术也可用于对全身麻醉下的患者进行检查。
概述全身麻醉下对新生儿和婴幼儿进行检查时术中OCT（iOCT）的应用可能性。
分析近期文献（PubMed）以及科隆大学医院眼科中心的初步经验。
使用iOCT能够在全身麻醉下对儿童进行检查时实现实时高分辨率成像。眼前节的所有相关结构（包括角膜、晶状体、房角和虹膜）均可可视化。特别是当由于角膜混浊导致前房视野受限，iOCT除了能提供使用手术显微镜所获得的信息外，还能提供重要信息。这些信息对于患者的进一步治疗很重要。
在线iOCT是普通手术显微镜的一项有用扩展，尤其适用于全身麻醉下儿童的检查以及前房视野受限的情况。根据我们的经验，将这项技术应用于后极部异常情况也有意义，因为可以对黄斑和视神经乳头进行高分辨率成像。
