title: Microscope-Integrated Optical Coherence Tomography Angiography in the Operating Room in Young Children With Retinal Vascular Disease.
abstract: Intraoperative optical coherence tomography (OCT) has gained traction as an important adjunct for clinical decision making during vitreoretinal surgery, and OCT angiography (OCTA) has provided novel insights in clinical evaluation of retinal diseases. To date, these two technologies have not been applied in combination to evaluate retinal vascular disease in the operating suite.
  
  
  
  To conduct microscope-integrated, swept-source OCTA (MIOCTA) in children with retinal vascular disease.
  
  
  
  In this case report analysis, OCT imaging in pediatric patients, MIOCTA images were obtained during examination under anesthesia from a young boy with a history of idiopathic vitreous hemorrhage and a female infant with familial exudative vitreoretinopathy.
  
  
  
  Side-by-side comparison of research MIOCT angiograms and clinically indicated fluorescein angiograms.
  
  
  
  In 2 young children with retinal vascular disease, the MIOCTA images showed more detailed vascular patterns than were visible on the fluorescein angiograms although within a more posterior field of view. The MIOCTA system allowed visualization of small pathological retinal vessels in the retinal periphery that were obscured in the fluorescein angiograms by fluorescein staining from underlying, preexisting laser scars.
  
  
  
  This is the first report to date of the use of MIOCTA in the operating room for young children with retinal vascular disease. Further optimization of this system may allow noninvasive detailed evaluation of retinal vasculature during surgical procedures and in patients who could not cooperate with in-office examinations.
authors.affiliation: Department of Ophthalmology, Duke University, Durham, North Carolina.
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Biomedical Engineering, Duke University, Durham, North Carolina.
authors.forename: Christian
authors.initials: C
authors.lastname: Viehland
authors.affiliation: Department of Biomedical Engineering, Duke University, Durham, North Carolina.
authors.forename: Oscar M
authors.initials: OM
authors.lastname: Carrasco-Zevallos
authors.affiliation: Department of Biomedical Engineering, Duke University, Durham, North Carolina.
authors.forename: Brenton
authors.initials: B
authors.lastname: Keller
authors.affiliation: Department of Ophthalmology, Duke University, Durham, North Carolina.
authors.forename: Lejla
authors.initials: L
authors.lastname: Vajzovic
authors.affiliation: Department of Biomedical Engineering, Duke University, Durham, North Carolina.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Izatt
authors.affiliation: Department of Ophthalmology, Duke University, Durham, North Carolina2Department of Biomedical Engineering, Duke University, Durham, North Carolina.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Toth
mesh_terms: D002675:Child, Preschool; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D005654:Fundus Oculi; D006801:Humans; D007223:Infant; D008297:Male; D008853:Microscopy / Q000379:methods*; D016343:Monitoring, Intraoperative / Q000379:methods*; D009873:Operating Rooms; D012160:Retina / Q000000981:diagnostic imaging* / Q000601:surgery; D012164:Retinal Diseases / Q000175:diagnosis* / Q000601:surgery; D041623:Tomography, Optical Coherence / Q000379:methods*