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, 27 (5), 589-96

Non-contact Ultra-Widefield Imaging of Retinopathy of Prematurity Using the Optos Dual Wavelength Scanning Laser Ophthalmoscope

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Non-contact Ultra-Widefield Imaging of Retinopathy of Prematurity Using the Optos Dual Wavelength Scanning Laser Ophthalmoscope

C K Patel et al. Eye (Lond).

Abstract

Aims: The purpose of this report is to demonstrate that a non-contact ultra-widefield dual wavelength laser camera (Optos) is able to capture high-quality images in retinopathy of prematurity (ROP).

Materials and methods: We conducted a retrospective review of patients attending the Oxford Eye Hospital with ROP between 1 August 2012 and 16 November 2012 that underwent standard clinical assessment. Anterior segment imaging, where relevant, was performed with Retcam. Retinal imaging was then performed with Optos, using a modified 'flying baby position'.

Results: The Optos scanning laser ophthalmoscope was able to acquire ultra-widefield fundal images in nine ROP subjects. The images obtained show clear views of the different stages of ROP features at the posterior pole and peripheral retina. Regression of ROP features were identified, following laser and intravitreal bevacizumab treatment. Additionally, 'skip areas' missed by initial laser treatment could be identified in the peripheral retina.

Conclusion: The Optos ultra-widefield scanning laser ophthalmoscope is capable of acquiring clinically useful high-quality images of the fundus in ROP subjects. The imaging technique could potentially be used in monitoring ROP progression and documenting ROP regression following treatment.

Figures

Figure 1
Figure 1
(a) Modified ‘flying baby position'. (b) Pseudo-colour fundal Optos images of a CPAP baby's right eye with APROP before Avastin injection: prominent plus disease with circumferential neovascular proliferation in zone 1 (white arrows) was noted. The CPAP is visible (yellow arrow). (c) Pseudo-colour fundal Optos images of a CPAP baby's right eye with APROP after Avastin injection: improvement in plus disease was noted (d, e). Pseudo-colour fundal Optos images of a baby with resolved stage 3, zone-1 ROP. Scarring in zone 2 of the right eye and zone 3 of the left eye was noted (white arrows).
Figure 2
Figure 2
(a) Pseudo-colour fundal Optos image of a baby's right eye with stage 1, zone-3 ROP (white arrows). (b) Pseudo-colour fundal Optos image of a baby's right eye with stage 2, zone-2 ROP (white arrows). (c) Pseudo-colour fundal Optos image of a baby's left with stage 3, zone-2 ROP and multifocal retinal haemorrhages. Extra-retinal neovascularisation was seen (white arrows).
Figure 3
Figure 3
(a–d) Pseudo-colour fundal Optos images of a baby with stage 3, zone-2 ROP with plus disease—extra-retinal neovascularisation (white arrows in (a, b)) was noted in both eyes. The quality of image obtained in the right eye was not affected by an existing corneal scar (blue arrow in (a)). One week after diode laser treatment, a skip area supero-temporally (yellow arrows in (c)) was seen. (e) Pseudo-colour fundal Optos image of a baby's right eye with stage-4b ROP—fibrous tissue associated with a tractional retinal detachment (white arrows) was noted. Yellow arrow notes position of the optic disc. (f) Pseudo-colour fundal Optos image of a baby's left eye after laser treatment of stage-4a ROP—skip areas were noted nasally.
Figure 4
Figure 4
(a–c) Pseudo-colour fundal Optos images of a baby's left eye with threshold ROP in zone 2 (white arrows in (a)). Extra-foveal retinal detachment infero-temporally (blue arrow in (b)) was noted. The residual circular cicatrix that required support from an encircling band was seen in (c). (d) Pseudo-colour fundal Optos image of a 7-year-old child's left eye with a history of treated stage 3, zone-1 ROP. This case was imaged through a small pupil (bottom left picture).

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