Evaluation of the nerve fiber layer and macula in the eyes of healthy children using spectral-domain optical coherence tomography

Evaluation of peripapillary retinal nerve fiber layer, macula and ganglion cell thickness in amblyopia using spectral optical coherence tomography

AIM

To investigate peripapillary retinal nerve fiber layer (RNFL), macula and ganglion cell layer thicknesses (GCC) in amblyopic eyes with spectral domain optical coherence tomography (SD-OCT).

METHODS

Thirty six patients with a history of unilateral amblyopia and thirty two children who had emmetropia without amblyopia were included in this study. In this institutional study, 36 eyes of 36 patients with amblyopia (AE), 36 fellow eyes without amblyopia (FE), and 32 eyes of 32 normal subjects (NE) were included. RNFL, GCC and macular thickness measurements were performed with RS-3000 OCT Retina Scan (Nidek Inc CA. USA).

RESULTS

The mean global thicknesses of the RNFL were 113.22±21.47, 111.57±18.25, 109.96±11.31µm in the AE, FE, and NE, respectively. There was no statistically significant difference for mean global RNFL thickness among the eyes (P=0.13). The mean thicknesses of the macula were 258.25±18.31, 258.75±19.54, 248.62±10.57µm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of macula among the eyes (P=0.06). The GCC was investigated into two parts: superior and inferior. The mean thicknesses of superior GCC were 102.57±13.32, 103.32±10.64, 100.52±5.88µm in the AE, FE, and NE, respectively. The mean thicknesses of inferior GCC were 103.82±12.60, 107.82±12.33, 105.86±10.79µm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of superior and inferior GCC between the eyes (P=0.63, P=0.46).

CONCLUSION

The macular thicknesses of AE and FE were greater than the NE, although it was not statistically significant. Amblyopia does not seem to have a profound effect on the RNFL, macula and GCC.

Multicenter Spanish study of spectral-domain optical coherence tomography in normal children

PURPOSE

To compile a multicenter normative database of retinal nerve fibre layer (RNFL) and macular thicknesses and macular volume values in healthy Caucasian children 4-17 years using spectral-domain optical coherence tomography (SD-OCT). To analyse variations in the OCT measurements as a function of age, sex, refraction, and axial length (AL).

METHODS

An observational, multicenter and cross-sectional study among 301 healthy Caucasian children recruited at three Spanish centres was performed. To compile the database, each child underwent a dilated eye examination and a cycloplegic refraction, five AL measurements (IOL Master; Carl Zeiss Meditec, Dublin, CA, USA), five OCT scans with Cirrus OCT: three peripapillary RNFL scans (Optic Disc Cube 200X200 protocol) and two macular scans (Macular Cube 512X128 protocol). One eye of each subject was selected randomly for analysis.

RESULTS

Two hundred eighty-three children (117 boys, 41.34%; 166 girls, 58.66%) were included in this study. The mean age of the children was 9.58 ± 3.12 years (range, 4-17). The mean SE was +0.63 ± 1.65 D; (range, -4.88 to +5.25). The mean AL was 22.94 ± 1.10 mm (range, 20.10-26.27). The mean global RNFL thickness was 97.40 ± 9.0 μm (range, 77-121.7 μm). Multivariate analysis showed a positive correlation between the RNFL and spherical equivalent (SE) (p = 0.014). The mean central macular thickness was 253.85 ± 19.76 μm, the average thickness 283.62 ± 14.08 μm, and the mean macular volume 10.22 ± 0.49 μm(3) . Multivariate analysis showed a positive correlation between central macular thickness and age (p < 0.001). Boys had a significantly thicker central macula than girls (p < 0.001).

CONCLUSIONS

Normative paediatric SD-OCT data might facilitate use of SD-OCT for assessing childhood ophthalmic diseases. This study provides a multicenter paediatric normative database of SD-OCT peripapillary RNFL and macular data.

Normative reference ranges for the retinal nerve fiber layer, macula, and retinal layer thicknesses in children

PURPOSE

To establish a normative database of peripapillary retinal nerve fiber layer (RNFL) thickness, macular thickness, and retinal layer thickness in healthy North American children, using spectral-domain optical coherence tomography (SD OCT).

DESIGN

Prospective cross-sectional study.

METHODS

This institutional study enrolled 83 healthy children (aged 5-15 years) as volunteer research subjects at the Retina Foundation of the Southwest (Dallas, Texas); all had normal visual acuity. Imaging was accomplished with the Spectralis SD OCT. Peripapillary RNFL thickness and macular thickness were assessed for 1 eye of each child using the Heidelberg Spectralis SD OCT software. Thicknesses of individual retinal layers and layer combinations were assessed using custom software to segment the line scans obtained with the Spectralis SD OCT.

RESULTS

Average global peripapillary RNFL thickness was 107.6 ± 1.2 μm and average central subfield macular thickness was 271.2 ± 2.0 μm. Peripapillary RNFL thickness was thicker than has been reported in adults, particularly the superior and inferior sectors, and central subfield macular thickness was significantly correlated with age. While the thickness of most retinal layers was comparable with those of adults, the outer segment layer was 36% thinner in children than in adults.

CONCLUSIONS

SD OCT can be used to assess peripapillary RNFL thickness, macular thickness, and retinal layer thickness in children as young as 5 years. Pediatric means and normative reference ranges are provided for each measurement. The values presented herein can be used as a standard with which to compare those of children suspected of having retinal or optic nerve abnormalities.

Retinal nerve fiber layer and optic disc measurements by spectral domain OCT: normative values and associations in young adults

PURPOSE

To determine normative values and associations of retinal nerve fiber layer (RNFL) and optic disc parameters in normal eyes measured by spectral domain optical coherence tomography (OCT).

METHODS

In a population-based setting, 1521 young adults were examined as part of the Sydney Adolescent Vascular and Eye Study (SAVES). Their mean age was 17.3±0.6 years. RNFL and optic disc parameter measurements were made using Cirrus HD-OCT 4000.

RESULTS

The average RNFL was found to be 99.4±9.6 μm. RNFL thickness was least for the temporal quadrant (69.9±11.2 μm), followed by the nasal (74.3±12.8 μm), superior (124.7±15.7 μm) and inferior (128.8±17.1 μm) quadrants. The mean disc area in this population was 1.98±0.38 mm(2) with a mean rim area of 1.50±0.30 mm(2) and a mean cup/disc ratio of 0.44±0.18. Multivariate-adjusted RNFL thickness was marginally greater in East Asian than in white participants (100.1 μm vs 99.5 μm; P=0.0005). The RNFL was thinner with greater axial length (P<0.0001), less positive spherical equivalent refractions (P<0.0001), smaller disc area and rim area (P<0.0001).

CONCLUSION

This study documents normative values for the RNFL and optic disc measured using Cirrus HD-OCT in young adults. The values and associations reported in this study can inform clinicians on the normal variation in RNFL and optic disc parameters.