Optical Coherence Topography in Pediatric Ophthalmology

Abstract

OCT has been applied in pediatric ophthalmology in many conditions without difficulties and its application will certainly expand relating to its non-contact and noninvasive effective method of obtaining in vivo high resolution information regarding retinal morphologic features, providing a comprehensive macular examinationfor children during examination under anesthesia(EUA) or in conjunction with an examination under sedation. To overcome the limitations in pediatric practice, the technology has evolved to more portable units, which also help image more peripheral lesions. Anterior segment OCT is used for the evaluation of glaucoma throughthe measurement of the anterior chamber inner diameter, and provides a pachymetric map.It is used for evaluation of ectatic disorders, corneoscleral abnormalities, corneal transplant follow up, and anterior segment tumors. Posterior segment OCT system (820 nm) allows the demonstration of mean values to the foveal thickness (186 microns) and nerve fiber layer thickness (108.27 microns), allowing an analysis of the optical disc and description of the macular morphology in premature children.

Stratus OCT was able to detect macular edema in a juvenile idiopathic arthritis–related uveitis of the eyes, evaluate fundus lesions in retinal capillary hemangioma, astrocytichamartoma, and retinoblastoma, measure RNFL thicknessclarify the morphology of foveal hypoplasia in pediatric albinism, localize posterior ROP pathology not evident on standard examination. New technology of OCT is introduced nowadays including swept source OCT, OCT angiography and intraoperative OCT. Swept source devices will also employ long-wavelength OCT light sources, which will greatly augment visualization of the choroid,OCT angiographyprovide noninvasive mapping of the retinal and/or choroidalmicrovasculature. Intraoperative OCT imaging is useful during evaluations and surgery of pediatric ophthalmology. It minimize the length of surgery and the iatrogenic potential damage (i.e. cataract development), by this it improves surgical management and outcome. The intraoperative have great value in objective confirmation of macular integrity from a medicolegal point of view.