Development of a clinical prototype of a miniature hand-held optical coherence tomography probe for prematurity and pediatric ophthalmic imaging

Abstract

We report a novel design and operation of a highly integrated miniature handheld OCT probe, with high-speed angiography function that can be used in clinical settings for young children and infants, providing rapid, non-invasive structural and angiographic imaging of the retina and choroid. The imaging system is operated at 200 kHz, with 3D OCT and OCTA scan time of 0.8 and 3.2 seconds, respectively, and the scanning angle on the pupil is ± 36°, covering the full perifoveal region. Operator assisting features of the direct-view iris camera and on-probe display are integrated into the hand-held probe, and the fixation target can display animations to attract the attention of young subjects. Compared to conventional OCT systems, the high-speed hand-held OCT system significantly improves the operator's experience and scanning efficiency, which is important for imaging infants. Imaging results indicate a significant reduction in total time consumption in pediatric ophthalmic imaging sessions, as well as the image quality of OCT angiography.

Quantitative Handheld Swept-Source Optical Coherence Tomography Angiography in Awake Preterm and Full-Term Infants

“…Eight premature infants (16 eyes) and 12 full-term infants (24 eyes) were enrolled in this study. Among premature infants, five infants included in the previous studies 22 , 27 were also included in this study. The study was approved by the institutional review board of Seattle Children's Hospital and the University of Washington (Seattle, Washington), which also conformed to the tenets of the Declaration of Helsinki and the Health Insurance Portability and Accountability Act.…”

“… 18 – 26 Our group reported a portable handheld clinical prototype SS-OCTA system optimized for imaging awake infants. 22 The handheld OCTA probe features a unique on-probe display for directly previewing the OCT B-scan results, a built-in iris viewer for rapidly aligning the probe with the patient's optical axis, and joystick controls to adjust the reference optical delay and fiber polarization state. The capability of this system was demonstrated on healthy adults and nonsedated preterm and full-term infants with high-quality four-layer OCTA (superficial retina, deep retina, choriocapillaris, and deep choroid).…”

“…The capability of this system was demonstrated on healthy adults and nonsedated preterm and full-term infants with high-quality four-layer OCTA (superficial retina, deep retina, choriocapillaris, and deep choroid). 22 , 27 …”

Handheld spectrally encoded coherence tomography and reflectometry for motion-corrected ophthalmic optical coherence tomography and optical coherence tomography angiography

“…Groups have recently described handheld OCT probes and demonstrated OCTA imaging in awake and sedated infants. 41,42 However, we believe the integrated motion tracking and realtime retinal aiming capabilities of SECTR provide significant advantages for point-of-care ophthalmic diagnostic imaging over these previous technologies. Here, we demonstrated an efficient motion-correction method in single OCT volumes and proof-of-concept multivolumetric mosaicking of OCTA projections.…”

“…[38][39][40] However, these studies were performed using OCT systems that had limited aiming and retinal-tracking functionality. Similarly, while groups recently published handheld OCT probes optimized for pediatric imaging, 41,42 these devices lack integrated motion tracking, widefield imaging, and real-time retinal-aiming capabilities that are necessary to overcome current limitations in point-of-care ophthalmic diagnostic imaging. We believe that our handheld SECTR imaging probe will improve image quality, enable robust structural and functional imaging, and benefit clinical ergonomics for imaging bedridden and pediatric patients.…”