The use of non-contact ultra-widefield imaging devices in infants

Thesis

The ability to image the peripheral retina is important for the diagnosis and management of infants with proliferative retinopathies. With the current retinal imaging techniques available for infants, peripheral sweeps and montage techniques are necessary when information about the retinal periphery is required. These techniques are labour intensive, require highly skilled photographers, and do not permit the simultaneous capture of the posterior pole and the retinal periphery in a single image. A recent technological advance has been the development of non-contact ultra-widefield retinal imaging devices, which can capture simultaneously the posterior pole and the retinal periphery in a single image. Image acquisition with these imaging modalities in the infant patient population has not been well studied. This thesis aimed to evaluate non-contact ultra-widefield retinal imaging in infants with retinal diseases.

A retrospective review of all infants who had non-contact ultra-widefield retinal imaging at the Oxford Eye Hospital with the Optos Panoramic 200MA and/or the Heidelberg Spectralis between July 2012 and July 2014 was conducted. An analysis of all retinal images was performed for each ultra-widefield imaging device to determine the quality of each retinal image acquired. Adequate quality images were used for analysis of captured peripheral retinal features and artefacts.

A total of 82 infants (range, 33 weeks postnatal age to 6 months old) diagnosed with retinopathy of prematurity, incontinentia pigmenti, or familial exudative vitreoretinopathy had non-contact ultra-widefield retinal imaging. Eleven infants who underwent general anaesthesia had intravenous fundus fluorescein angiography (FFA) with the Heidelberg Spectralis in the operating room. Seventy-one infants were imaged with the Optos Panoramic 200MA in the outpatient setting. Of the 71 infants imaged with the Optos Panoramic 200MA, 42 infants had pseudocolour fundus imaging and 29 infants had FFA. Of the 29 infants who had FFA with the Optos Panoramic 200MA, 23 infants had sodium fluorescein administered intravenously and 6 infants had sodium fluorescein administered orally. A total of 2389 adequate quality ultra-widefield retinal images were analysed for peripheral retinal features and artefacts. A range of peripheral retinal features was adequately captured with both ultra-widefield imaging devices. Artefacts that decreased the field of view were present in images acquired from both ultra-widefield imaging devices.

The Optos Panoramic 200MA and the Heidelberg Spectralis were both capable of acquiring clinically useful, high resolution, ultra-widefield retinal images in infants with a range of retinal diseases.

Authors: Fung, T

• Alternative title: Ultra-widefield imaging in infants
• DOI: 10.5287/ora-yj47ardxg
• Type of award: MSc by Research
• Level of award: Masters
• Awarding institution: University of Oxford