Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Utilizing near infra-red spectroscopy to identify physiologic variations during digital retinal imaging in preterm infants

Journal of Perinatology volume 42, pages 378–384 (2022)Cite this article

Subjects

Abstract

Objective

Evaluate physiologic changes during digital retinal imaging (DRI) using near infra-red spectroscopy (NIRS).

Study design

Prospective observational study of preterm infants undergoing retinopathy of prematurity screening via DRI using wide-field retinal camera. Cardiorespiratory (CR) and NIRS data were collected, trends correlated for changes and coefficient representing “slopes” of outcomes were plotted over time. The p value associated with each slope coefficient was tested to assess for slope differences from time of intervention (time = 0/or no slope).

Results

Thirty-one preterm infants were included in the study. There were no significant changes in pre- and post-slopes for cerebral or mesenteric oxygenation, or CR indices with eye drop administration compared to baseline. DRI resulted in significant increase in post exam slope in cerebral oxygenation, mesenteric oxygenation and respiratory rate.

Conclusion

ROP examination using DRI was well tolerated with slight improvements in cerebral and mesenteric perfusion without significant safety concerns.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Figure demonstrating changes in slopes for cerebral perfusion, mesenteric perfusion and other cardiorespiratory indices following dilating eye drop application for retinopathy of prematurity examination.
Fig. 2: Figure demonstrating changes in slopes for cerebral perfusion, mesenteric perfusion and other cardiorespiratory indices over time following digital retinal imaging using wide field retinal camera for retinopathy of prematurity examination.

Similar content being viewed by others

References

  1. Purisch SE. Epidemiology of preterm birth. Semin Perinatol. 2017;41:387–91.

    Article  Google Scholar 

  2. Gilbert C. Childhood blindness in the context of VISION 2020-the right to sight. Bull World Health Organ. 2003;79:227–32.

    Google Scholar 

  3. Rahi JS. Severe visual impairment and blindness in children in the UK. Lancet. 2003;362:1359–65.

    Article  Google Scholar 

  4. Fierson WM. Screening Examination of Premature Infants for Retinopathy of Prematurity. Pediatrics. 2018;142:1–9.

    Article  Google Scholar 

  5. Kovács G, Somogyvari Z, Maka E, Nagyjanosi L. Bedside ROP screening and telemedicine interpretation integrated to a neonatal transport system: Economic aspects and return on investment analysis. Early Hum Dev. 2017;106:1–5.

    Article  Google Scholar 

  6. Richter GM, Williams SL, Starren J, Flynn TJ, Chiang MF. Telemedicine for retinopathy of prematurity diagnosis: evaluation and challenges. Surv Ophthalmol. 2009;54:671–85.

    Article  Google Scholar 

  7. Ells AL, Holmes JM, Astle WF, Willians G, Leske DA, Fielden M, et al. Telemedicine approach to screening for severe retinopathy of prematurity: a pilot study. Ophthalmology. 2003;110:2113–7.

    Article  Google Scholar 

  8. Slevin M, Murphy JF, O’Keefe M. Retinopathy of prematurity screening, stress related responses, the role of nesting. Br J Ophthalmol. 1997;81:762–4.

    Article  CAS  Google Scholar 

  9. Fijalkowski N, Zheng LL, Henderson MT, Wang SK, Wallenstein MB, Leng T, et al. Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP): five years of screening with telemedicine. Ophthalmic Surg Lasers Imaging Retin. 2014;45:106–13.

    Article  Google Scholar 

  10. Mukherjee AN, Watts P, Al-Madfai H, Manoj B, Roberts D. Impact of retinopathy of prematurity screening examination on cardiorespiratory indices: a comparison of indirect ophthalmoscopy and retcam imaging. Ophthalmology. 2006;113:1547–52.

    Article  Google Scholar 

  11. Vesoulis ZA, Mintzer JP, Chock VY. Neonatal NIRS monitoring: recommendations for data capture and review of analytics. J Perinatol. 2021;41:675–88.

    Article  Google Scholar 

  12. Pavlek LR, Mueller C, Jebbia MR, Kielt MJ, Fathi O. Near-Infrared Spectroscopy in Extremely Preterm Infants. Front Pediatrics. 2021;8;973.

    Article  Google Scholar 

  13. Bailey SM, Hendricks-Munoz KD, Mally P. Cerebral, renal, and splanchnic tissue oxygen saturation values in healthy term newborns. Am J Perinatol. 2014;31:339–44.

    PubMed  Google Scholar 

  14. Vesoulis ZA, Lust CE, Liao SM, Trivedi SB, Mathur AM. Early hyperoxia burden detected by cerebral near-infrared spectroscopy is superior to pulse oximetry for prediction of severe retinopathy of prematurity. J Perinatol. 2016;36:966–71.

    Article  CAS  Google Scholar 

  15. van der Heide M, Hulscher JBF, Bos AF, Kooi. EMW Near-infrared spectroscopy as a diagnostic tool for necrotizing enterocolitis in preterm infants. Pediatric Res. 2021;90:148–155.

    Article  CAS  Google Scholar 

  16. Schat TE, Zoonen AGJF, van der Laan ME, Mebius MJ, Bos AF, Hulzebos CV, et al. Early cerebral and intestinal oxygenation in the risk assessment of necrotizing enterocolitis in preterm infants. Early Hum Dev. 2019;131:75–80.

    Article  Google Scholar 

  17. Ostojic D, Jiang J, Isler H, Kleiser S, Karen T, Wolf M, et al. Impact of Skull Thickness on Cerebral NIRS Oximetry in Neonates: an in silico Study. Adv Exp Med Biol. 2020;1232:33–38.

    Article  CAS  Google Scholar 

  18. van Bel F, Lemmers P, Naulaers G. Monitoring Neonatal Regional Cerebral Oxygen Saturation in Clinical Practice: Value and Pitfalls. Neonatology. 2008;94:237–44.

    Article  Google Scholar 

  19. Ranger M, Albert A, MacLean K, Holsti L. Cerebral hemodynamic response to a therapeutic bed for procedural pain management in preterm infants in the NICU: a randomized controlled trial. Pain Rep. 2021;6:e890.

  20. Alderliesten T, van Bel F, van derAa NE, Steendijk P, van Haastert IC, de Vries LS, et al. Low Cerebral Oxygenation in Preterm Infants Is Associated with Adverse Neurodevelopmental Outcome. J Pediatrics. 2019;207:109–16.

    Article  Google Scholar 

  21. Variane GFT, Chock VY, Netto A, Pietribom RFR, Van Meurs KP. Simultaneous Near-Infrared Spectroscopy (NIRS) and Amplitude-Integrated Electroencephalography (aEEG): Dual Use of Brain Monitoring Techniques Improves Our Understanding of Physiology. Front Pediatrics. 2019;7:1–8.

    Google Scholar 

  22. Marin T, Moore J, Kosmetatos N, Roback JD, Weiss P, Higgins M, et al. Red blood cell transfusion-related necrotizing enterocolitis in very-low-birthweight infants: a near-infrared spectroscopy investigation. Transfusion. 2013;53:2650–8.

    Article  CAS  Google Scholar 

  23. Braski K, Weaver-Lewis K, Loertscher M, Ding Q, Sheng X, Baserga M. Splanchnic-Cerebral Oxygenation Ratio Decreases during Enteral Feedings in Anemic Preterm Infants: Observations under Near-Infrared Spectroscopy. Neonatology. 2018;113:75–80.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors gratefully acknowledge the contributions of their subjects, their subjects’ families, and their colleagues. This work has been supported by departmental funds.

Author information

Authors and Affiliations

  1. Department of Pediatrics, UMass Chan Medical School - Baystate, Springfield, MA, USA

    Ruben Vaidya, Edward Zitnik, Timothy Kita, Kathryn Wagner & Rachana Singh

  2. University of Massachusetts, Amherst, MA, USA

    Kathryn Wagner

  3. Office of Research, UMass Chan Medical School - Baystate, Springfield, MA, USA

    Peter St. Marie & Paul Visintainer

  4. Department of Pediatrics, Tufts Children’s Hospital, Boston, MA, USA

    Rachana Singh

Authors
  1. Ruben Vaidya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Edward Zitnik
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Timothy Kita
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kathryn Wagner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peter St. Marie
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paul Visintainer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rachana Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization/design/methodology: RV, EZ, TK, PV, PS, RS. Investigation/formal analysis: RV, KW, PS, PV, RS. Paper drafting: RV, EZ, TK, RS. Paper editing: All authors. All authors gave final approval of the version to be published. All authors agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Ruben Vaidya.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

The study was reviewed and approved by Baystate Health Institutional Review Board and was exempt from requiring written consent.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vaidya, R., Zitnik, E., Kita, T. et al. Utilizing near infra-red spectroscopy to identify physiologic variations during digital retinal imaging in preterm infants. J Perinatol 42, 378–384 (2022). https://doi.org/10.1038/s41372-021-01294-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-021-01294-1

This article is cited by

Search

Advanced search

Quick links