Preterm Infant Stress During Noncontact Handheld Optical Coherence Tomography and Contact Fundus Photography

Area of Science:

• Neonatal ophthalmology
• Medical imaging technology
• Pediatric critical care

Background:

• Retinopathy of prematurity (ROP) assessments can induce stress in preterm infants.
• Minimizing stress during ROP examinations is crucial for infant well-being.
• Evaluating novel imaging techniques for less invasive ROP screening is important.

Purpose of the Study:

• To compare the stress levels of preterm infants during ROP examinations using noncontact optical coherence tomography (OCT) versus contact fundus photography.
• To assess adverse events associated with each imaging modality.

Main Methods:

• A prospective cohort study was conducted in a single tertiary care center's intensive care nursery.
• Preterm infants underwent ROP examinations using both investigational handheld noncontact OCT and contact fundus camera in a randomized order.
• Infant stress was measured using the Modified CRIES score, heart rate, and oxygen saturation, with adverse events also recorded.

Main Results:

• Noncontact OCT resulted in significantly lower changes in cry score, facial expression score, and heart rate compared to fundus photography.
• Adverse events, including tachycardia, bradycardia, and hypoxia, were significantly less frequent with OCT imaging.
• No ocular, unexpected, or severe adverse events were reported for either imaging method.

Conclusions:

• Noncontact handheld OCT appears to be a less stressful imaging modality for preterm infants undergoing ROP examinations.
• The use of noncontact OCT may reduce the incidence of adverse events associated with ROP screening.
• Further investigation into the role of handheld OCT for ROP screening is warranted.