Peripheral OCT Assisted by Scleral Depression in Retinopathy of Prematurity.

OBJECTIVE

To determine whether handheld widefield optical coherence tomography (OCT) can be used to document retinopathy of prematurity (ROP) stage while using scleral depression to improve peripheral views.

DESIGN

Prospective observational study.

PARTICIPANTS

Consecutive neonates admitted to the neonatal intensive care unit (NICU) in a single academic medical center who also met criteria for ROP screening and consented for research imaging.

METHODS

Scleral depression was combined with widefield OCT using an investigational 400-kHz, 55-degree field of view handheld OCT during routine ROP screening from October 28, 2020 to March 03, 2021.

MAIN OUTCOME MEASURES

Acquisition of and B-scan imaging of the peripheral retina to objectively assess early vitreoretinal pathology, including the demarcation between vascularized and anterior avascular retina, the presence of early ridge formation, and small neovascular tufts.

RESULTS

Various stages of ROP were detected using a rapid acquisition OCT system. In one neonate, serial OCT imaging over a five-week period demonstrated accumulation of neovascular tufts with progression to stage 3 ROP with extraretinal fibrovascular proliferation along the ridge. Videography of this technique is included in this report for instructional purposes.

CONCLUSIONS

Serial examinations using widefield OCT and scleral depression is feasible and may improve detection and documentation of ROP disease progression. Earlier detection of ROP-related proliferation may prevent vitreoretinal traction, retinal detachment, and blindness.