Handheld 400kHz optical coherence tomography angiography visualizes microvascular details in infants with advanced retinopathy of prematurity

Abstract

Clinical evaluation of the disease activity of retinopathy of prematurity (ROP) is routinely performed via indirect ophthalmoscopy and/or widefield fundus photography. Herein we report an infant with advanced ROP imaged with an investigational handheld 400kHz optical coherence tomography angiography system that visualized microvascular details not seen in fundus exam or photography.

Fig. 1

Fundus photography, fluorescein angiography and handheld OCTA imaging of microvascular details in an infant with advanced retinopathy of prematurity. The 400kHz handheld OCTA system was used to image a male infant (born at 23 weeks GA) at 64 weeks PMA with zone 2 stage 4A ROP during examination under anesthesia. (A) Montaged OCTA images with 110 × 40° field-of-view. RetCam (B) fundus photo and (C) fluorescein angiographs of the same patient with a 130° field-of-view. (D) OCT B-scans with flow overlay showed visualization of microvascular details and pronounced extraretinal (blue asterisk) and intraretinal (red asterisk and arrows) neovascularization. (E) When visualized in two layers, the deep vascular complex (DVC) showed sparse vascular pattern compared to the superficial vascular complex (SVC), likely resulting from the developing microvasculature projecting from the superficial to deep retinal layers. (F) OCT B-scan through area of retinal elevation showed retinoschisis without retinal detachment (B-scan location marked with dashed green line in B). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)