A digital system for imaging the pediatric fundus, the RetCam, is requested. High-resolution images of the entire retina and magnified images of the optic nerve head (optic disc) and macula can be obtained. RetCam images surpass those that can be obtained with currently available fundus cameras. Each major user has a funded, clinical research study of infants and children with a history of preterm birth. Dr. Volpe and Dr. DuPlessis, investigate periventricular leukomalacia (PVL) which has associated abnormalities of the optic nerve head (optic disc). In these patients, analysis of the RetCam images of the optic nerve head (optic disc) provide an unprecedented oppoitunity to examine the relationship of disc fuatures and clinical history, structure of the periventricular white matter, visual and neurological function. Dr. Vanderveen is involved in the multicenter study, The Early Treatment of ROP (ETROP) in which subjects are enrolled and studied at preterm ages with postterm follow-up. Topography of acute ROP during its evolution and resolution will be documented with detail and accuracy that is currently impossible. For those subjects in the treatment arm of the ETROP study, the RetCain images will support the diagnosis of pre-threshold and threshold ROP, and document the response to laser treatment. Dr. Fulton and Dr. Hansen, enroll the former pretemis at postterm ages, but categorize subjects according to maximum acute phase ROP (determined at preterm ages). For this study of development of retinal function and refractive error in ROP subjects, RetCam images will document and refine the observations upon which their categorization of acute phase ROP is based. The RetCam images of the entire retinal surface area, combined with biometry of the globe, allow estimates retinal surface area in eyes with ROP, including those with multiple, small areas of retina ablated by laser treatment. These data will facilitate analysis of ERG results. The highly magnified RetCam images of the macula, including those obtained with fluorescein angiography, will, provide new information about this late-maturing portion of the central retina that may be paiticularly vulnerable to the ROP. The minor users will take advantage of the wide field images as well as the highly magnified views of the macula and optic nerve head (optic disc), including the fluorescein capability.
