Lee Helena, Proudlock Frank A, Gottlob Irene
Clinical and Experimental Sciences Faculty of Medicine, University of Southampton, Southampton, United Kingdom 2University of Leicester Ulverscroft Eye Unit, Leicester, United Kingdom.
University of Leicester Ulverscroft Eye Unit, Leicester, United Kingdom.
Invest Ophthalmol Vis Sci. 2016 Jul 1;57(9):OCT69-79. doi: 10.1167/iovs.15-18825.
Optical coherence tomography (OCT) has revolutionized the diagnosis and management of adult retinal and optic nerve disease. Children were deprived of this technology until the recent development of handheld spectral-domain OCT (HH-SDOCT). In this article, we review the applications of OCT imaging in pediatric ophthalmology.
This study was a review of the literature.
The acquisition and interpretation of pediatric tomograms differ significantly from those for adults, with adjustments needed to account for the shorter axial lengths, higher refractive errors, and ongoing retinal and optic nerve development in the pediatric eye. Handheld SDOCT is increasingly being used as an adjunctive diagnostic tool in retinopathy of prematurity (ROP) and nonaccidental injury (NAI) by providing additional morphologic information that is not normally clinically discernible. The role of HH-SDOCT in streamlining diagnosis in infantile nystagmus syndrome, retinal dystrophies, and degenerations has been established. Optical coherence tomography can also help differentiate between pediatric intraocular tumors, for example, hamartomas and retinoblastoma; monitor tumor progression; and monitor treatment response. In addition, HH-SDOCT is establishing its role as a noninvasive monitoring tool in children affected by optic nerve pathology such as glaucoma, optic nerve atrophy and hypoplasia, optic pathway glioma, and pseudotumor cerebri.
Handheld SDOCT can provide novel insights into the natural history of retinal and optic nerve diseases in young children. For example, in achromatopsia and albinism, in vivo OCT studies have provided evidence of altered but ongoing retinal development in early childhood, which suggests that potentially targeting treatment at an earlier age may optimize visual function by normalizing retinal development.
光学相干断层扫描（OCT）彻底改变了成人视网膜和视神经疾病的诊断与治疗。在手持式光谱域OCT（HH-SDOCT）最近研发出来之前，儿童一直无法使用这项技术。在本文中，我们回顾了OCT成像在小儿眼科中的应用。
本研究为文献综述。
儿童断层扫描的采集和解读与成人有显著差异，需要进行调整以考虑小儿眼球较短的眼轴长度、较高的屈光不正以及视网膜和视神经仍在发育的情况。手持式SDOCT越来越多地被用作早产儿视网膜病变（ROP）和非意外性损伤（NAI）的辅助诊断工具，它能提供额外的形态学信息，而这些信息通常在临床上难以辨别。HH-SDOCT在简化婴儿型眼球震颤综合征、视网膜营养不良和变性疾病的诊断方面的作用已得到确立。光学相干断层扫描还可以帮助鉴别小儿眼内肿瘤，例如错构瘤和视网膜母细胞瘤；监测肿瘤进展；以及监测治疗反应。此外，HH-SDOCT正在确立其作为一种非侵入性监测工具在患有视神经病变（如青光眼、视神经萎缩和发育不全、视神经通路胶质瘤和假性脑瘤）儿童中的作用。
手持式SDOCT可以为幼儿视网膜和视神经疾病的自然病程提供新的见解。例如，在全色盲和白化病中，活体OCT研究提供了证据，表明幼儿期视网膜发育虽有改变但仍在进行，这表明在更早的年龄进行潜在的靶向治疗可能通过使视网膜发育正常化来优化视觉功能。
