Spectral Domain Optical Coherence Tomography Imaging of the Eyes of Neonates

Brief Summary

The purpose of this study is to better characterize the retina and optic nerve in newborns
using spectral domain optical coherence tomography (s-oct). This new technology provides a
very detailed cross-section picture of the cellular layers in the retina and a 3-dimensional
picture of the optic nerve head and the fovea (the center of the retina that provides the
most accurate vision). These images have been used by doctors for more than 5 years to help
diagnose and treat adults with eye diseases, such as macular degeneration, diabetic
retinopathy, retinal detachments, and melanoma. But, it has never been studied in newborns.
In newborns, it would potentially help in the diagnoses of glaucoma, optic nerve hypoplasia,
foveal hypoplasia, and colobomata among many other disorders. Prior to diagnosing disorders,
it is necessary to establish normal values. It is the purpose of this investigation to study
the retina and optic nerves in neonates to establish normal values.

After a parent of a normal newborn provides a written consent, the baby will be taken to the
Eye Clinic where the instrument is located. The baby will be swaddled in one or more
blankets as needed. The infants will be held in front of the instrument by a nurse. The
technician will move the lens of the instrument to about 2 to 4 inches from the baby's eye.
The mild light from the instrument will then enter the eye for a few seconds to obtain the
desired image. The image can be captured through an immobile eye within 5 seconds. If the
baby is fussy, he or she may be given a few drops of a sugar (sucrose) solution on a
pacifier for calming. Although the images can usually be secured through a normal pupil, if
the pupil is found to be too small, two drops of Cyclomydril will be placed on the eye for
dilation. This is the eye drop used everyday in the Eye Clinic and nursery to dilate the
pupils of babies. The dilation will last for about 6 to 10 hours. After the test, the baby
will return to the nursery or be discharged home as intended by the Neonatology Division.

There is minimal risk associated with this investigation. The instrument is non-invasive and
does not touch the eye. The babies will be swaddled and held by a nurse to prevent any
contact with the machine. The eye drop to be used if needed for dilation has been used on
babies at Harbor for about 30 years. It has been found to very safe. The fact that we will
study only term (not premature babies) and will apply only two drops if needed should
minimize any risk from the eye drop.

An ethical issue to consider is that while the study will provide important information that
will undoubtedly help babies in the future, it will probably not benefit the baby being
studied. However, if the baby has an undetected retinal or optic nerve problem, the study
may reveal it.