Pediatric OCT prototype will help examine premature eyes

A first-generation system was tested using a mannequin and rabbits, and a second-generation system is expected to be ready for use on human infants this summer, said Arlanna N. Moshfeghi, MD, MPH, assistant professor of clinical ophthalmology in the pediatric ophthalmology department, Bascom Palmer Eye Institute, University of Miami.

"It's still in the prototype stage, but very soon we hope to move it into the operating room and start using it on children," she said. Dr. Moshfeghi described the OCT system during a presentation at the Association for Research in Vision and Ophthalmology.

"Our idea was to create a platform that could safely support an infant or small child so that we could move the child into the proper position for the OCT to be at the same level as the child's eye," Dr. Moshfeghi said. "It sounded like a simple idea, but it was difficult because we were dealing with really small infants. They all have to be sedated, so we had to have something that would be safe enough for an anesthetized child with IV leads and tubes coming out of their mouth. We had to be sensitive to that."

The engineering designs were made using 3-D CAD software and anthropometric data on infants. Cradles were designed to hold premature infants, babies 1 year or less, and children aged 1 to 3 years and up to 45 pounds. The design allows easy access to the child in the event of an emergency.

A bead-filled, three-section vacuum bag holds the infant without compression to the head, thoracic cage, abdomen, arms, or legs, yet leaves space to position a tracheal tube, EKG leads, pulse, pressure monitoring cuff, and IV lines. The system permits proper vertebral and head position to free the airway and prevent tracheal tube motion. Safety mechanisms include a magnetic lock holding the device to the table and Velcro straps.

The hope is that the pediatric OCT system can be used with a RetCam and B-scan ultrasound to perform a wider range of examinations on infants, Dr. Moshfeghi said. She added that the cradle could be modified so that many tests routinely performed on older children and adults could be performed on infants.