Every year, some 16,000 babies in the U.S. experience loss of vision due to retinopathy of prematurity (RoP), with 400 to 600 becoming legally blind, according to the National Eye Institute. When babies are born prematurely, their retinal blood vessels don't always develop fully, and the abnormal vessels are more prone to leaking and contracting. If that causes the retina to detach, babies can lose some or all vision.
A new handheld device, developed in part by biomedical engineers at Duke University Medical Center, uses something called spectral domain optical coherence tomography (SD OCT) to create a 3D image of the back of the eye.
Duke Eye Center ophthalmologist Cynthia Toth compares the process to inspecting fish from the side of an aquarium instead of through an ocean's murky surface; the 3D high-resolution map reveals the retina's layers in intricate detail "at almost the cellular level," she says.
The technology itself isn't new; it was pioneered by ophthalmologists at Duke Eye Center more than a decade ago. But in the past two years, Toth says, they've begun exploring how to apply this technology to examining retinal diseases in children. Recent advances in OCT inspired Joseph Izatt, a professor of biomedical engineering and ophthalmology at Duke, to engineer a handheld probe that can take photos more than 40 times faster than previous OCT devices.
Since it is handheld, the device can be taken to infants in the neonatal ICU, and can be used without ever touching an infant's eye. Not having to transport the premature babies out of the ICU is a big step, Toth says. Now that the imaging is proving so successful, it's time to determine what role the imaging 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.
The device is manufactured by Bioptigen, a Duke spinout company for whom Izatt is the chairman and chief technology officer. Research was supported by Angelica and Euan Baird, The Hartwell Foundation, the North Carolina Biotechnology Center, and the National Institutes of Health.