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

光学相干断层扫描（OCT）的最新发展提供了活体显微镜精度的眼睛后部（视网膜）图像。这有助于成人视网膜疾病的诊断和治疗取得重大进展。然而，光学相干断层扫描目前在临床上并不适用于幼儿。正常的视网膜在出生时并不成熟，直到大约45个月才会发生显著的变化，从而导致视力改善。我们的目标是使用新开发的手持式OCT设备首次可视化从出生到6岁的视网膜变化，并比较年龄较大的儿童和成人的结果。OCT将在大量眼睛正常的儿童和患有发育性眼部问题的儿童中进行，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中。我们将调查这些患者出生后视网膜发育是否“停滞”或减慢。我们的目的是确定OCT图像是否可以帮助诊断和预测的视力在言语前的婴儿和视力发展以后的生活。我们希望这项研究将有助于了解眼球震颤的原因，不自主的眼球运动经常发生在儿童的视网膜问题。我们预计，我们的研究将是一个重要的一步，在验证和提供访问OCT在新生儿，婴儿和幼儿。我们旨在从正常儿童中获得的数据也将为使用OCT研究其他疾病奠定基础，例如早产儿的视网膜问题，青光眼或视网膜色素变性。以高精度检查幼儿体内视网膜结构将是评估和确定即将进行的基因治疗（例如色盲）的重要组成部分。

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.