Retinal Imaging for Pediatric Patients

Abstract

Retinal imaging is useful in diagnosis, prognosis, medicolegal documentation, and medical decision making for treatment. Imaging can also provide structural and functional information not discernable solely by physical examination, especially in patients with unexplained vision loss or hereditary retinal diseases. Spectral domain optical coherence tomography can reveal macular ultrastructural defects via an in vivo “optical biopsy.” Scanning laser ophthalmoscope-based imaging platforms are gaining popularity over traditional flash fundus photography for ease of use, speed of image acquisition, simultaneous multimodal imaging, and ultra-wide-field capabilities. Patients 3 years and older can usually cooperate with outpatient imaging not requiring intravenous access. Most kinds of retinal imaging and full-field electroretinography can be obtained during examination under anesthesia if the procedures are too invasive and painful, or preclude cooperation of an awake patient. Although imaging is a powerful tool, it is intended to supplement, not replace, a thorough history and physical examination for medical decision making.