TY - JOUR
T1 - Pediatric Vitreoretinal Surgery and Integrated Intraoperative Optical Coherence Tomography
AU - Cai, Sophie
AU - Therattil, Anthony
AU - Vajzovic, Lejla
N1 - Funding Information:
S.C.: None A.T.: Heidelberg Engineering - research grant; Orbit Biomedical - research grant L.V.: Alcon - consultant, research grant; Zeiss - research equipment; Heidelberg Engineering - research grant, research equipment.
Publisher Copyright:
© 2021 S. Karger AG, Basel.
PY - 2021
Y1 - 2021
N2 - Intraoperative portable handheld and microscope-integrated OCT enhance the pediatric vitreoretinal surgeon's diagnostic abilities during examination under anesthesia and surgery, particularly in children who are challenging to examine preoperatively due to young age or ocular trauma. Improved OCT-guided visualization of vitreoretinal anatomic relationships has the potential to improve surgical safety and efficiency. In retinopathy of prematurity and other pediatric retinal vascular conditions, intraoperative OCT can be critical for distinguishing between retinoschisis and retinal detachment and highlighting abnormalities of the vitreoretinal interface that may contribute to development of tractional retinal detachments. During retinal detachment repair, intraoperative OCT aids identification of subtle retinal breaks, residual subretinal fluid, retained perfluorocarbon, preretinal membranes, and residual hyaloid, among other findings. In macular surgery, intraoperative OCT has demonstrated value in confirming completion or lack thereof of epiretinal and internal limiting membrane peeling and differentiating between lamellar and full-thickness macular holes. OCT-guided subretinal bleb formation and genetic vector delivery are critical to ensuring accurate localization of subretinal gene delivery for inherited retinal degenerations. Research on development of OCT-compatible surgical instruments, real-time three-dimensional volumetric OCT imaging, and integration with intraoperative OCT angiography are anticipated to further increase the utility of intraoperative OCT in pediatric vitreoretinal surgical decision-making.
AB - Intraoperative portable handheld and microscope-integrated OCT enhance the pediatric vitreoretinal surgeon's diagnostic abilities during examination under anesthesia and surgery, particularly in children who are challenging to examine preoperatively due to young age or ocular trauma. Improved OCT-guided visualization of vitreoretinal anatomic relationships has the potential to improve surgical safety and efficiency. In retinopathy of prematurity and other pediatric retinal vascular conditions, intraoperative OCT can be critical for distinguishing between retinoschisis and retinal detachment and highlighting abnormalities of the vitreoretinal interface that may contribute to development of tractional retinal detachments. During retinal detachment repair, intraoperative OCT aids identification of subtle retinal breaks, residual subretinal fluid, retained perfluorocarbon, preretinal membranes, and residual hyaloid, among other findings. In macular surgery, intraoperative OCT has demonstrated value in confirming completion or lack thereof of epiretinal and internal limiting membrane peeling and differentiating between lamellar and full-thickness macular holes. OCT-guided subretinal bleb formation and genetic vector delivery are critical to ensuring accurate localization of subretinal gene delivery for inherited retinal degenerations. Research on development of OCT-compatible surgical instruments, real-time three-dimensional volumetric OCT imaging, and integration with intraoperative OCT angiography are anticipated to further increase the utility of intraoperative OCT in pediatric vitreoretinal surgical decision-making.
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U2 - 10.1159/000511818
DO - 10.1159/000511818
M3 - Article
C2 - 33647898
AN - SCOPUS:85102294592
SN - 0250-3751
VL - 61
SP - 15
EP - 25
JO - Developments in ophthalmology
JF - Developments in ophthalmology
ER -