Ultra-high resolution optical coherence tomography (UHR-SD OCT) in infants and children: characterisation of normal and abnormal foveal development

光学相干层析成像(OCT)的最新发展提供了眼后部(视网膜)的图像，具有活人显微镜的精确度。这有助于在成人视网膜疾病的诊断和治疗方面取得重大进展。然而，OCT目前还不适用于幼儿。正常的视网膜在出生时并不成熟，直到大约45个月时才发生显著变化，导致视力改善。我们的目标是使用一种新开发的手持OCT设备首次可视化出生到6岁时视网膜的变化，并比较年龄较大的儿童和成年人的结果。OCT将在大量眼睛正常的儿童和有发育问题的儿童身上进行，这些问题可能发生在白化病(色素缺乏)、色盲或其他遗传问题上。我们将调查这些患者出生后视网膜发育是否“停止”或减慢。我们的目标是确定OCT图像是否可以帮助诊断和预测分娩前婴儿的视力以及在以后的生活中发育的视力。我们希望这项研究将有助于了解眼球震颤的原因，眼球震颤是视网膜问题儿童经常发生的非自主眼球运动。我们预计，我们的研究将是验证和提供新生儿、婴儿和幼儿OCT的重要一步。我们希望从正常儿童那里获得的数据也将为使用OCT研究其他疾病奠定基础，如早产儿的视网膜问题、青光眼或视网膜色素变性。高精度地检查小孩子体内的视网膜结构将是评估和选择即将到来的基因治疗的重要组成部分，例如在色盲中。

The recent development of optical coherence tomography (OCT) provides pictures of the back of the eye (the retina) with the precision of a microscope in living people. This has contributed to significant progress in the diagnosis and treatment of retinal diseases in adults. However, OCT is not currently clinically available for young children.The normal retina is not mature at birth and undergoes significant changes until about 45 months leading to visual improvement. We aim to visualise for the first time changes in the retina from birth to 6 years of age using a newly developed hand-held OCT device, comparing also results in older children and adults. OCTs will be performed in a large amount of children with normal eyes and in children with developmental eye problems which can occur, for example, in albinism (pigment deficiency), colour blindness or other genetic problems. We will investigate whether retinal development is "arrested" or slowed down after birth in these patients. We aim to determine whether OCT images can assist in the diagnosis and prediction of vision in preverbal infants and of the vision developing later in life. We hope that this study will help to understand the cause of nystagmus, involuntary eye movements frequently occurring in children with retinal problems.We anticipate that our study will be an important step in validating and providing access of OCT in newborns, infants and young children. The data we aim to acquire from normal children will also lay the ground to investigate other diseases using OCT such as retinal problems of premature children, glaucoma or retinitis pigmentosa. To examine retinal structures in vivo in small children with high precision will be an important component of evaluating and timing imminent gene therapy, for example in achromatopsia.