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Flying baby optical coherence tomography alters the staging and management of advanced retinopathy of prematurity
Author(s) -
CehajicKapetanovic Jasmina,
Xue Kanmin,
Purohit Ravi,
Patel Chetan K.
Publication year - 2021
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14613
Subject(s) - retinopathy of prematurity , optical coherence tomography , medicine , optometry , coherence (philosophical gambling strategy) , ophthalmology , pediatrics , physics , gestational age , pregnancy , genetics , biology , quantum mechanics
Purpose To report the use of flying baby spectral domain optical coherence tomography (SD‐OCT) on infants with advanced retinopathy of prematurity (ROP), where clinical findings alone failed to differentiate between retinoschisis and retinal detachment. Methods Prospective, non‐interventional case‐series study of three premature infants with advanced ROP of clinically uncertain stage, after examination by indirect ophthalmoscopy. To confirm the diagnosis, table‐mounted SD‐OCT retinal imaging was performed with the infant held in the flying baby position under topical ocular anaesthesia only. Spectral domain optical coherence tomography (SD‐OCT) findings were correlated with clinical examination and ultra‐widefield scanning laser ophthalmoscopy to determine disease stage and appropriate management. Results The flying baby position was well tolerated, and SD‐OCT images of central and peripheral retina were successfully obtained in all three cases. Additional information provided by the SD‐OCT changed the ROP staging from 3 to 4 in one case, which subsequently required surgical treatment. In two other cases, clinical suspicion of stage 4 ROP was overruled as SD‐OCT revealed tractional retinoschisis rather than full‐thickness retinal detachment, thereby avoiding the need for immediate surgical intervention. Conclusions In this case‐series study, flying baby SD‐OCT provided a rapid and widely accessible imaging approach that overruled clinical findings and altered classification and management of infants with advanced ROP. The methodology was suitable for outpatient settings with no risks associated with systemic anaesthesia. The increased use of OCT imaging will make apparent how structural information is useful in management of ROP and may influence future classification of the disease.