Handheld Optical Coherence Tomography in Paediatric Ophthalmology: Experience of the Department of Ophthalmology in Giessen

Abstract

Introduction: Optical coherence tomography is an important tool for the imaging and analysis of retinal structures. The usability of conventional table-top devices is limited in children. We report on our experiences with a handheld Spectral Domain Optical Coherence Tomography (HH-SD-OCT, Bioptigen™) in infants and young children in our daily practice. Methods: Between October 2014 and April 2016, we investigated 259 patients. Indications and diagnoses were assessed. Individual examples are shown to demonstrate the advantages and disadvantages of the novel technique. Results: It was possible to examine 259 children of at least 7 weeks of age (median: 1.59 years; ± 1.32 SD) with a mean investigation time of 18.3 minutes (± 8.3 SD). The most frequent indication was retinal assessment in prematures (32.8 %). Nystagmus, retinal dystrophies, reduced visual acuity and albinism amounted to additional 37.4 % of all indications. Conclusions: Handheld OCT is a beneficial complement for diagnosis of diseases in paediatric ophthalmology. As a complement to established methods like wide-field fundus photography, HH-SD-OCT allows the physician to assess and follow-up new objective structural information. As the Bioptigen does not have an eye tracker, it is challenging to orient the scan in the posterior retinal pole, in particular in case of instable fixation. This complicates follow-up investigations, which can only be performed with additional high programming and analysis effort.