title: Fundus imaging in newborn children with wide-field scanning laser ophthalmoscope.
abstract: OBJECTIVE
  Current fundus imaging in newborn babies requires mydriatics, eye specula and corneal contact. We propose that a scanning laser ophthalmoscope (SLO) allows ultra wide-field imaging with reduced stress for the child.
  
  
  METHODS
  This prospective observational single centre study was conducted in Landspítali, University Hospital, Reykjavik, Iceland. In this study, a noncontact wide-field SLO (Optomap 200Tx) was used to image the retina in healthy full-term newborns without the use of mydriatics or eye specula. The child was held by one of the parents, while one of the researchers supported the child's head in front of the SLO camera for alignment and opened the eye with either a finger or a cotton tip.
  
  
  RESULTS
  Fifty-nine participants were recruited (34 females). The mean age was 16 days, and the mean gestational age was 40 ± 1 weeks at the time of imaging. Ultra-wide-field (200°) images were obtained of 44 participants. Twenty-seven participants (61%) had at least one ultra wide-field image with the optic disc and vessel segments in all quadrants of the fundus visible and in focus. No retinal pathology was found in the participants with the exception of one participant with small retinal haemorrhages.
  
  
  CONCLUSIONS
  Scanning laser ophthalmoscope (SLO) ultra-wide-field fundus imaging is feasible in healthy full-term newborns without corneal contact, eye speculum or mydriatics. This approach could be an improvement for retinal imaging in newborn infants. Eye movement of the infant, whether asleep or awake, influenced which part of the fundus was captured, but focus and image quality were generally good.
authors.affiliation: Department of Ophthalmology, Landspítali University Hospital, University of Iceland, Reykjavik, Iceland.|Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.
authors.forename: Vigdis
authors.initials: V
authors.lastname: Magnusdottir
authors.affiliation: Department of Ophthalmology, Leiden University Medical Center, University of Leiden, Leiden, Netherlands.
authors.forename: Wouter B
authors.identifier: http://orcid.org/0000-0002-2616-6397
authors.initials: WB
authors.lastname: Vehmeijer
authors.affiliation: Department of Ophthalmology, Landspítali University Hospital, University of Iceland, Reykjavik, Iceland.
authors.forename: Thorunn S
authors.initials: TS
authors.lastname: Eliasdottir
authors.affiliation: Department of Ophthalmology, Landspítali University Hospital, University of Iceland, Reykjavik, Iceland.
authors.forename: Sveinn H
authors.initials: SH
authors.lastname: Hardarson
authors.affiliation: Department of Ophthalmology, Leiden University Medical Center, University of Leiden, Leiden, Netherlands.
authors.forename: Nicoline E
authors.initials: NE
authors.lastname: Schalij-Delfos
authors.affiliation: Department of Ophthalmology, Landspítali University Hospital, University of Iceland, Reykjavik, Iceland.
authors.forename: Einar
authors.initials: E
authors.lastname: Stefánsson
mesh_terms: D004867:Equipment Design; D005260:Female; D005654:Fundus Oculi; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008266:Macula Lutea / Q000000981:diagnostic imaging*; D008297:Male; D019721:Ophthalmoscopes; D009887:Ophthalmoscopy / Q000379:methods*; D011446:Prospective Studies; D012016:Reference Values
keywords: eye speculum; infants; mydriatics; retina; scanning laser ophthalmoscope; wide-field images