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Published on: March 11, 2016
Fundus imaging in newborn children with wide-field scanning laser ophthalmoscope
Vigdis Magnusdottir1,2, Wouter B Vehmeijer3, Thorunn S Eliasdottir1
1Department of Ophthalmology, Landspítali University Hospital, University of Iceland, Reykjavik, Iceland.
Insights
Scanning laser ophthalmoscope (SLO) enables stress-free, ultra-wide-field retinal imaging in newborns. This noncontact method avoids eye drops and specula, improving the experience for infants and parents.
Area of Science:
- Ophthalmology
- Neonatal Care
- Medical Imaging
Background:
- Current neonatal fundus imaging necessitates mydriatics, eye specula, and corneal contact.
- These methods can cause significant stress for newborn infants.
Purpose of the Study:
- To evaluate the feasibility of using a noncontact scanning laser ophthalmoscope (SLO) for ultra-wide-field retinal imaging in healthy newborns.
- To assess if SLO imaging can be performed without mydriatics or eye specula, reducing infant stress.
Main Methods:
- A prospective observational study involving healthy, full-term newborns was conducted.
- A noncontact, wide-field SLO (Optomap 200Tx) was utilized without mydriatics or eye specula.
- Infants were supported by parents, with eyes gently opened for imaging.
Main Results:
- Ultra-wide-field (200°) retinal images were successfully obtained in 44 out of 59 healthy newborns.
- Sixty-one percent of participants had at least one image showing the optic disc and all retinal quadrants in focus.
- No significant retinal pathology was detected, apart from one case of minor retinal hemorrhages.
Conclusions:
- Scanning laser ophthalmoscope (SLO) ultra-wide-field fundus imaging is a feasible and less stressful alternative for examining newborn retinas.
- This noncontact approach eliminates the need for mydriatics and eye specula, offering an improvement in neonatal retinal imaging.
- Image quality was generally good, though infant eye movements affected the captured fundus area.
Purpose:
Current fundus imaging in newborn babies requires mydriatics, eye specula and corneal contact. We propose that a scanning laser ophthalmoscope (SLO) allows ultra wide-field imaging with reduced stress for the child.
Methods:
This prospective observational single centre study was conducted in Landspítali, University Hospital, Reykjavik, Iceland. In this study, a noncontact wide-field SLO (Optomap 200Tx) was used to image the retina in healthy full-term newborns without the use of mydriatics or eye specula. The child was held by one of the parents, while one of the researchers supported the child's head in front of the SLO camera for alignment and opened the eye with either a finger or a cotton tip.
Results:
Fifty-nine participants were recruited (34 females). The mean age was 16 days, and the mean gestational age was 40 ± 1 weeks at the time of imaging. Ultra-wide-field (200°) images were obtained of 44 participants. Twenty-seven participants (61%) had at least one ultra wide-field image with the optic disc and vessel segments in all quadrants of the fundus visible and in focus. No retinal pathology was found in the participants with the exception of one participant with small retinal haemorrhages.
Conclusion:
Scanning laser ophthalmoscope (SLO) ultra-wide-field fundus imaging is feasible in healthy full-term newborns without corneal contact, eye speculum or mydriatics. This approach could be an improvement for retinal imaging in newborn infants. Eye movement of the infant, whether asleep or awake, influenced which part of the fundus was captured, but focus and image quality were generally good.
