TY - JOUR
T1 - Preterm infant stress during handheld optical coherence tomography vs binocular indirect ophthalmoscopy examination for retinopathy of prematurity
AU - BabySTEPS Group
AU - Mangalesh, Shwetha
AU - Sarin, Neeru
AU - McGeehan, Brendan
AU - Prakalapakorn, S. Grace
AU - Tran-Viet, Du
AU - Cotten, C. Michael
AU - Freedman, Sharon F.
AU - Maguire, Maureen G.
AU - Toth, Cynthia A.
AU - Chen, Xi
AU - El-Dairi, Maysantoine
AU - Farsiu, Sina
AU - Grace, Sara
AU - Gustafson, Kathryn E.
AU - Izatt, Joseph
AU - Pizoli, Carolyn
AU - Vajzovic, Lejla
AU - Viehland, Christian
AU - Wallace, David
AU - McCall, Michelle
AU - Finkle, Joanne
AU - Imperio, Ryan
AU - Raynor, William
AU - Chiu, Stephanie
AU - Divecha, Heena
AU - Tai, Vincent
AU - Winter, Katrina P.
AU - Seely, Kai
AU - Wang, Kira
AU - Wong, Brittany
AU - Ying, Gui Shuang
AU - Shimony, Joshua
AU - Alexopoulos, Dimitrios
AU - Kaplan, Sydney
AU - Kenley, Jeanette
AU - Hannon, Kayla
AU - Smith, P. Brian
AU - O'Shea, Michael
AU - Kurgatt, Subashri
N1 - Publisher Copyright:
© 2021 American Medical Association.
PY - 2021/5
Y1 - 2021/5
N2 - IMPORTANCE Binocular indirect ophthalmoscopy (BIO) examination for retinopathy of prematurity (ROP) is a well-known cause of repeated preterm infant stress. OBJECTIVE To compare stress during investigational optical coherence tomography (OCT) imaging to that during BIO for ROP. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study examined infants at the bedside in the intensive care nursery. Consecutive preterm infants enrolled in Study of Eye Imaging in Preterm Infants (BabySTEPS) who had any research OCT imaging as part of the study. Patients were recruited from June to November 2019, and analysis began April 2020. MAIN OUTCOMES AND MEASURES Infant stress was measured using modified components of a neonatal pain assessment tool before (baseline) and during OCT imaging and BIO examination of each eye. RESULTS For 71 eye examinations of 16 infants (mean [SD] gestational age, 27 [3] weeks; birth weight, 869 [277] g), change from baseline to each eye examination was lower during OCT imaging than during BIO and the difference between OCT imaging and BIO at each eye examination was significant for the following: infant cry score (first eye examination: mean [SD], 0.03 [0.3] vs 1.68 [1.2]; -1.65 [95% CI, -1.91 to -1.39]; second eye examination: mean [SD], 0.1 [0.3] vs 1.97 [1.2]; -1.87 [95% CI, -2.19 to -1.54]), facial expression (first eye: 3 [4%] vs 59 [83%]; -79% [95% CI, -87% to -72%]; second eye: 4 [6%] vs 61 [88%]; -83% [95% CI, -89% to -76%]), and heart rate (first eye: mean [SD], -7 [16] vs 13 [18]; -20 [95% CI, -26 to -14]); second eye: mean [SD], -3 [18] vs 20 [20] beats per minute; -23 [95% CI, -29 to -18]) (P <.001 for all). Change in respiratory rate and oxygen saturation did not differ between OCT imaging and BIO. CONCLUSIONS AND RELEVANCE While the role of OCT alone or in combination with BIO is currently unknown for ROP, these findings suggest that investigational OCT imaging of ROP is less stressful than BIO examination by a trained ophthalmologist.
AB - IMPORTANCE Binocular indirect ophthalmoscopy (BIO) examination for retinopathy of prematurity (ROP) is a well-known cause of repeated preterm infant stress. OBJECTIVE To compare stress during investigational optical coherence tomography (OCT) imaging to that during BIO for ROP. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study examined infants at the bedside in the intensive care nursery. Consecutive preterm infants enrolled in Study of Eye Imaging in Preterm Infants (BabySTEPS) who had any research OCT imaging as part of the study. Patients were recruited from June to November 2019, and analysis began April 2020. MAIN OUTCOMES AND MEASURES Infant stress was measured using modified components of a neonatal pain assessment tool before (baseline) and during OCT imaging and BIO examination of each eye. RESULTS For 71 eye examinations of 16 infants (mean [SD] gestational age, 27 [3] weeks; birth weight, 869 [277] g), change from baseline to each eye examination was lower during OCT imaging than during BIO and the difference between OCT imaging and BIO at each eye examination was significant for the following: infant cry score (first eye examination: mean [SD], 0.03 [0.3] vs 1.68 [1.2]; -1.65 [95% CI, -1.91 to -1.39]; second eye examination: mean [SD], 0.1 [0.3] vs 1.97 [1.2]; -1.87 [95% CI, -2.19 to -1.54]), facial expression (first eye: 3 [4%] vs 59 [83%]; -79% [95% CI, -87% to -72%]; second eye: 4 [6%] vs 61 [88%]; -83% [95% CI, -89% to -76%]), and heart rate (first eye: mean [SD], -7 [16] vs 13 [18]; -20 [95% CI, -26 to -14]); second eye: mean [SD], -3 [18] vs 20 [20] beats per minute; -23 [95% CI, -29 to -18]) (P <.001 for all). Change in respiratory rate and oxygen saturation did not differ between OCT imaging and BIO. CONCLUSIONS AND RELEVANCE While the role of OCT alone or in combination with BIO is currently unknown for ROP, these findings suggest that investigational OCT imaging of ROP is less stressful than BIO examination by a trained ophthalmologist.
UR - http://www.scopus.com/inward/record.url?scp=85103579150&partnerID=8YFLogxK
U2 - 10.1001/jamaophthalmol.2021.0377
DO - 10.1001/jamaophthalmol.2021.0377
M3 - Article
C2 - 33792625
AN - SCOPUS:85103579150
SN - 2168-6165
VL - 139
SP - 567
EP - 574
JO - JAMA Ophthalmology
JF - JAMA Ophthalmology
IS - 5
ER -