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Clinic-based ultra-wide field retinal imaging in a pediatric population
Nikisha Kothari1, Stacy Pineles1, David Sarraf1
1Department of Ophthalmology, Stein Eye Institute, Doheny Eye Institute, University of California, Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095 USA.
Insights
Ultra-wide field imaging is effective for assessing pediatric retinal disorders in children as young as 3 years old without sedation. This advanced imaging provides valuable data for diagnosing and monitoring various eye conditions in pediatric patients.
Area of Science:
- Ophthalmology
- Medical Imaging
- Pediatrics
Background:
- Pediatric retinal disorders can be difficult to diagnose, often necessitating sedation for examination.
- Evaluating these conditions in children presents unique clinical challenges.
- Ultra-wide field (UWF) retinal imaging offers a potential solution for non-sedated outpatient assessments.
Observation:
- A retrospective case series included 55 patients (107 eyes) aged 3-18 years undergoing UWF imaging.
- Common diagnoses included retinopathy of prematurity, trauma, Coats disease, and retinal detachment.
- Image analysis focused on field of view, autofluorescence patterns, and angiographic phases.
Findings:
- UWF imaging was successfully obtained in children without sedation, even in those as young as 3 years old.
- The number of retinal quadrants visualized correlated positively with patient age.
- Ultra-wide field fundus photography, UWF autofluorescence, and UWF angiography provided valuable diagnostic information.
Implications:
- UWF retinal imaging is a feasible and effective tool for evaluating pediatric retinal diseases in an outpatient setting.
- This technology can reduce the need for sedation, improving patient comfort and clinical workflow.
- UWF imaging aids in the documentation and monitoring of pediatric eye conditions, enhancing patient care.
Background:
Pediatric retinal disorders, although uncommon, can be challenging to assess in the clinic setting and often requires an exam under anesthesia. The purpose of our study was to evaluate the use of ultra-wide field retinal imaging in children without sedation in an outpatient clinic.
Methods:
We performed a retrospective case series of patients 18 years or younger who received ultra-wide field imaging over a one year period. The age, gender, and clinical course were documented. Color fundus and red-free images were reviewed to assess field of view. Ultra-wide field autofluorescence (UWF-FAF) was evaluated for abnormal autofluorescence patterns and ultra-wide field fluorescein angiography (UWF-FA) was assessed for angiographic phase and field of view.
Results:
A total of 107 eyes of 55 patients with a mean age of 11.1 years (SD 3.7 years, range 3-18 years) were evaluated. Twenty-seven (49%) patients were male. The most common diagnosis was retinopathy of prematurity (7 of 55 patients, 12.7%) followed by trauma (7.4%), Coats disease (7.4%), and rhegmatogenous retinal detachment (7.4%). The number of quadrants visualized anterior to the equator correlated with patient age (r = 0.4, p < 0.01). On UWF-FA, 6 of 14 patients (43%) had images of the arterial phase captured and 14 of 14 patients (100%) had images of the venous phase or later captured.
Conclusions:
We demonstrated that UWF imaging is obtainable in children as young as 3 years old without sedation. UWF fundus photography, UWF-FAF and UWF-FA were useful clinical adjuvants to examination and provide additional information for documenting and monitoring pediatric retinal diseases.
