Major Article
Longitudinal reproducibility of optical coherence tomography measurements in children

Presented as a Poster at the 37th Annual Meeting of the American Association for Pediatric Ophthalmology and Strabismus, San Diego, California, March 30-April 3, 2011.
https://doi.org/10.1016/j.jaapos.2012.08.011Get rights and content

Purpose

To evaluate the longitudinal reproducibility of optical coherence tomography (OCT) measurements in normal and glaucomatous eyes of children.

Methods

In this 2-setting prospective study, OCT-3 was used to obtain fast retinal nerve fiber layer (RNFL) and macular thickness scans. In the first study setting, the normal eyes of healthy children were scanned on presentation, at 2 weeks, and 3 years, with axial length measured at the first and last examinations. In the second setting, OCT scans of patients in the pediatric glaucoma clinic were performed over 4 years as clinically indicated. Eyes were classified as “normal” (normal eyes and those with physiologic cupping but normal intraocular pressure [IOP]); “mild glaucoma” (increased IOP and a normal optic nerve appearance); or “advanced glaucoma” (severe cupping or progressive glaucoma). Intraclass correlation coefficients were used to evaluate the reproducibility of measurements on the same day and over time.

Results

In the first setting, 8 normal eyes were included. Axial length increased 0.11 ± 0.04 mm/year over an average of 3.3 years (P = 0.03); there was no statistically significant change in RNFL thickness (P = 0.30). In our second setting, 27 normal eyes and 37 eyes with glaucoma were included. Intraclass correlation coefficients across the 3 visits for total macular volume were 0.80-0.91 and for average RNFL were 0.73-0.95.

Conclusions

Global OCT measurements in children were reproducible over years and were not affected by normal increase in axial length. OCT shows promise as an objective tool for longitudinal assessment of children.

Section snippets

Methods and Materials

This study was approved by the Duke Health System Institutional Review Board and complied with the requirements of the Health Insurance Portability and Accountability Act. Written informed consent was obtained for each subject from the legal guardian. Verbal assent was obtained from all subjects. Additional written assent was obtained from each child who was at least 12 years of age.

The Stratus OCT (Carl Zeiss, Dublin, CA) was used to obtain fast macular and fast RNFL 3.4 thickness protocols.8

Results

The first study setting included 8 normal eyes of 8 children. The average age at initial examination was 9.1 ± 2.3 years. The average time between the first and second visits was 0.2 years; between the first and third visits, 3.3 years. The ICC for total macular volume and average RNFL within visits showed very good reproducibility (0.91-0.98, Tables 1 and 2).

At the initial visit, the average axial length was 23.5 mm (range, 22.3-24.1), the average total macular volume was 7.0 mm3 (95%

Discussion

Among children with normal eyes as well as those with suspected or known glaucoma, global Stratus OCT measurements of total macular volume and average RNFL thickness were reproducible over several years. Among normal eyes, over an average of 3 years, there was a statistically significant increase in average axial length measurements; however, the change in average RNFL thickness as average axial length increased was not statistically significant. Although previous cross-sectional studies have

Literature Search

The authors searched PubMed (MEDLINE) for English-language only articles for the period 1946 to 2012 using combinations of the following search terms: pediatric glaucoma, OCT OR optical coherence tomography, reproducible OR reproducibility.

References (18)

There are more references available in the full text version of this article.

Cited by (27)

  • Optical Coherence Tomography Normative Peripapillary Retinal Nerve Fiber Layer and Macular Data in Children 0–5 Years of Age

    2019, American Journal of Ophthalmology
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    pRNFL global thickness showed a weak negative correlation with axial length in multiple regression analysis. Previous studies in children have shown no relationship between global pRNFL thickness and axial length in some29–31 and a negative correlation in others.32,33 Aykut and associates33 found that this relationship disappeared when a correction was applied for the effect of ocular magnification as it relates to axial length.

  • Handheld Optical Coherence Tomography Normative Inner Retinal Layer Measurements for Children <5 Years of Age

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    Axial length has been reported to have an inverse relationship with optic disc parameters, RNFL thickness, and macular thickness.26,47–50 Similar to Prakalapakorn and colleagues,35 we did not find a relationship between peripapillary RNFL and GCC thickness at the macula. While there are developmental changes at the level of the fovea, optic nerve, and axial length during early life, we have found a stable macular GCC volume and peripapillary RNFL thickness.

  • Normal optic nerve head: Anatomy and development

    2019, Handbook of Pediatric Retinal OCT and the Eye-Brain Connection
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Dr. Prakalapakorn is supported by NIH EY016333 and an unrestricted grant from Research to Prevent Blindness to the Duke Eye Center.

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