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Computed image of a section of retina from a spectral domain optical coherence tomography scan. (Courtesy: Ramiro Maldonado/Duke)

DUKE (US)—New imaging technology may go a long way to improving diagnosis and treatment of a condition that causes blindness in premature babies.

The hand-held device, developed in part by biomedical engineers at Duke University, uses spectral domain optical coherence tomography (SD OCT) to create a 3-D image of the back of the eye.

“This new tool is changing the way we identify eye conditions in infants,” says Cynthia Toth, professor of ophthalmology and biomedical engineering.

Retinopathy of prematurity (ROP) is one of the most common causes of vision loss in children, affecting about 16,000 babies each year, according to the National Eye Institute.

It occurs when babies are born prematurely and their retinal blood vessels don’t develop fully. Instead, the vessels grow abnormally and are prone to leaking and contracting. That can pull the retina out of position, causing retinal detachments that can lead to visual loss and blindness.

Presently, screening for ROP is done with the use of an ophthalmoscope or camera placed directly on the infant’s cornea.

“Examining the retina with these methods is like looking at the surface of the ocean and only seeing dimly into the shallow water,” says Toth. “You cannot see what lies below.”

SD OCT, on the other hand, uses a narrow beam of light to create a 3-D high-resolution map of the intricate detail in the retina’s layers.

“This is like looking into an aquarium from the side, where all the fish at every depth are visible,” Toth explains.

The new technology, which can take pictures more than 40 times faster than before, “reveals the retina in greater detail than was ever before realized, allowing us to observe disease at almost the cellular level” she says.

This means multiple scans of the eye now take only seconds. Also,  the portable handheld SD OCT system can be taken directly to premature infants in the incubator.

“Now, for the first time, we can take the SD OCT system into the neonatal intensive care unit and hold it over the infant’s eye without touching the eye and image the retina while the infant is lying in the bed,” she says. “We don’t have to transport the infants out of the intensive care unit, which makes the whole process much more comfortable for them and their parents.”

Toth says the next step is to determine what role the system could play in treatment decisions.

“Right now we’re analyzing data on more than 20 infants to identify how the SC OCT images of ROP relate to the usual examination and to decisions we make about treatment. What we hope to learn is whether what we see in the infant’s eyes today will help us to predict how their disease and vision will be in the future.”

Toth says this imaging technology could also be used with babies suspected of having a wide range of retinal diseases including albinism and retinal injury.

The study, which was supported by Angelica and Euan Baird, the Hartwell Foundation, the North Carolina Biotechnology Center, and the National Institutes of Health, appears online in the journal Ophthalmology.

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