Microscope-integrated intraoperative optical coherence tomography in examination of pediatric patients under anesthesia

Abstract

The therapeutic principle of examinations of children under general anaesthesia using microscope-integrated optical coherence tomography (MI-OCT) is presented. The aim was to assess novel indications as well as limitations for MI-OCT to enhance ophthalmological examinations of neonates and children under general anesthesia. The study was based on a review of the literature from google.scholar.com and PubMed and our own data from aprospective study (Department for Ophthalmology, University of Cologne) of 14children with anterior and posterior segment anomalies undergoing examinations under anesthesia. Patients were examined using acommercially available MI-OCT device. The study analyzed the general feasibility of MI-OCT for ophthalmological examination of children under general anesthesia for the anterior and posterior eye segments and the benefits of indications and intraoperative findings. The MI-OCT significantly enriched the examinations of children under general anesthesia and delivered additional information not visible with the surgical microscope. Even in situations with alimited anterior chamber view MI-OCT enabled estimation of distances, such as corneal thickness. In addition to influencing therapeutic decisions, in 12/14children MI-OCT also enabled examination of the thickness of the nerve fibre layer of the optic nerve disc and the retina. The data presented here underline the benefit of the intraoperative MI-OCT in ophthalmological examinations of children under general anesthesia. In particular MI-OCT enables examinations of children with corneal opacification, if an ophthalmological examination under general anesthesia becomes necessary.