ABSTRACT.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 lm (range, 77-121.7 lm). 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 lm, the average thickness 283.62 ± 14.08 lm, and the mean macular volume 10.22 ± 0.49 lm 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.

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ABSTRACT.Purpose: To evaluate the usefulness of optical coherence tomography (OCT) for follow-up of optic neuritis (ON) compared with subjective visual function tests. Methods: Twelve patients with ON underwent a complete ophthalmological evaluation at initial diagnosis, including best corrected visual acuity (VA), visual fields testing and OCT examination. These examinations were repeated periodically over 6 months. Retinal nerve fibre layer (RNFL) thickness evolution was analysed and correlated with VA and visual field mean deviation. Results: Six months after ON, mean RNFL in the affected eye decreased significantly compared with that in the fellow eye (24.54%). A significant correlation was found between RNFL thinning and final VA (r ¼ 0.807, p ¼ 0.005), with a 1-line drop in VA for every 5.4-lm decrease. All patients with an altered visual field had an abnormal RNFL value; of the seven patients with normal visual fields, 57% had an abnormal RNFL value (p < 5%). Conclusions: Optical coherence tomography can detect axonal damage as early as the third month after an isolated initial episode of ON, even in the presence of normal visual fields. Mean RNFL thinning is correlated with final VA.

Although patients with NAION have lower C/D ratios than does the normal population, with a higher level of nerve fiber crowding, there was no difference in optic disc size between patients with NAION and control subjects. After the development of NAION, 47.8% of eyes had a C/D ratio that differed from that in the fellow eye by more than 0.1.

In diffuse diabetic ME with no retinal traction, vitrectomy with either ILM peeling or IVTA injection at the end of surgery produces a short-term improvement in retinal thickness but no long-term anatomical or functional improvements.

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Intravitreal bevacizumab seems to be an effective primary treatment option for macular oedema due to retinal occlusions. Its main drawback is that multiple injections are necessary to maintain visual and anatomic improvements.

Optical coherence tomography (OCT) uses light interference patterns to produce a cross-sectional image of the retina. It is capable of measuring the unmyelinated axons of the retinal ganglionar cells as they converge on the optic disc. In a disease like multiple sclerosis (MS), in which axonal loss has been identified as an important cause of sustained disability, it may prove an invaluable tool. OCT has demonstrated that axonal loss occurs after each episode of optic neuritis and that the degree of axonal loss is correlated to visual outcomes. Furthermore, axonal loss occurs in MS even in the absence of inflammatory episodes, and the degree of this loss is correlated with the duration of the disease process, with more thinning as the disease advances and in progressive forms. Thus, OCT retinal nerve fiber layer measurements may represent an objective outcome measure with which to evaluate the effect of treatment.