A novel technique using spectral-domain optical coherence tomography (Spectralis, SD-OCT+HRA) to image supine non-anaesthetized infants: utility demonstrated in aggressive posterior retinopathy of prematurity.

PURPOSE: To acquire high definition spectral domain optical coherence tomography (SD-OCT) images of supine, non-anesthetized infants in the office by a novel modification of a commercially available table-top, chin rest system. METHOD: Spectralis, a combined HRA+OCT device (Heidelberg Engineering, Heidelberg, Germany) was modified to convert the table-top system into a hand-held device using a two-step modification of the existing system. This device was used to obtain high-resolution OCT images of four infants with aggressive posterior retinopathy of prematurity (APROP) who required no general anesthesia. RESULTS: Serial imaging at two time periods of the exact area of clinical interest were obtained and were comparable. The entire procedure was safely completed in the office. The obtained OCT images guided selective laser ablation of flat neovascularization which were missed on clinical examination. CONCLUSION: With this simple modification and technique, the ability of using the Spectralis, a popular combined angiography and OCT imaging device for imaging supine, non-anesthetized infants has been established. This possibility would allow the dual use of the table-top system to serve also as a hand-held device for paediatric cases that can be imaged in the office setting with limited operating room facility in a busy practice.