Assessment of macular ganglion cell complex using optical coherence tomography: Impact of a paediatric reference database in clinical practice

Abstract

Importance Optical coherence tomography software classifies abnormality of macular ganglion cell‐inner plexiform layer thickness and macular retinal nerve fibre layer thickness based on adult series. Background We assessed the impact of using paediatric reference macular ganglion cell complex values instead of adult reference values. Design Cross‐sectional study. Primary and tertiary health‐care setting. Participants Out of 140 healthy participants aged 5 to 18 years, 90% were eligible. Methods Following a dilated eye examination and cycloplegic refraction, participants underwent optical coherence tomography ganglion cell scans (Topcon 3D OCT‐2000; Topcon Corporation, Tokyo, Japan). Right eye measurements for superior, inferior, and total layer thickness and spherical equivalent were reported, together with age, sex and origin. Main Outcome Measures Paediatric reference values by age and spherical equivalent were produced, and the specific agreement between paediatric and adult ganglion cell complex reference values below or equal to percentile 5 was estimated. Results The multivariate analysis confirmed a positive association between spherical equivalent and macular ganglion cell‐inner plexiform layer thickness, and between age and macular retinal nerve fibre layer (five out of six regression coefficients P values were ≤ 0.03). Specific agreement was 25% for ganglion cell‐inner plexiform layer thickness and > 80% for macular retinal nerve fibre layer. Adult‐based software identified low ganglion cell values in one in seven children compared to paediatric reference values (0.8% vs 5.5%, P = 0.031). Conclusions and Relevance The availability of optical coherence tomography ganglion cell complex reference values for paediatric age and spherical equivalent groups can be used to improve detection of children with low cell layer thickness.

Interobserver reproducibility and interocular symmetry of the macular ganglion cell complex: assessment in healthy children using optical coherence tomography

“…Children aged ≥12 years also provided written informed assent. The study protocols adhered to the guidelines of the Declaration of Helsinki for research involving human participants [16].…”

“…The inclusion criteria have been previously detailed [16]. The macula 3D scan (V) protocol was used to evaluate the GCC.…”

“…Numerous authors to date have investigated the reproducibility of OCT in macular and optic nerve measurements in healthy children [3,[7][8][9][10][11][12][13]. To our knowledge, few studies have researched the values of GCL-IPL in healthy children, with one in children with refractive errors [14], one in healthy Turkish children [15], one in healthy Spanish children [16], and another that compared the result obtained in healthy children with the results for children with congenital glaucoma [17]. However, none of these studies included reproducibility analyses.…”

<p>Ganglion Cell Complex Analysis in Glaucoma Patients: What Can It Tell Us?</p>

“…61,62 The GCL-IPL values were found to be thicker in the pediatric population with respect to adults, confirming the necessity of using a pediatric reference database to avoid false estimation with the adult normative database. 63,64 The Utility of Ganglion Cell…”

Interobserver reproducibility and interocular symmetry of the macular ganglion cell complex: assessment in healthy children using optical coherence tomography

“…Numerous authors to date have investigated the reproducibility of OCT in macular and optic nerve measurements in healthy children [7-9, 3, 10-13]. To our knowledge, few studies have researched the values of GCL-IPL in healthy children, with one in children with refractive errors [14], one in healthy Turkish children [15], one in healthy Spanish children [16], and another that compared the result obtained in healthy children with the results for children with congenital glaucoma [17].…”