Evaluation of the Optic Disc and Macula in Healthy Children Using Optical Coherence Tomography Angiography

Abstract

Objectives: To perform the measurements of the optic disc and macula in healthy children using optical coherence tomography angiography (OCTA) in order to determine the normative data values and compare these by age, gender, spherical equivalent (SE), and axial length (AL). Materials and Methods: A total of 146 eyes belonging to 146 healthy children (74 girls, 72 boys) aged 6 to 16 years were included in this prospective study. Refraction and biometry measurements were performed. Retinal nerve fiber layer thickness (RNFLT), central macular volume, and central macular thickness (CMT) were measured by optical coherence tomography (OCT) after dilatation. Using the OCTA device, foveal avascular zone (FAZ) area, vascular density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of the macula, and the VD of the radial peripapillary capillary plexus (RPCP) of the optic disc were recorded. Results: The mean age of the study group was 11.27±3 years, the mean AL was 23.39±1.18 mm and the mean SE was -1.31±1.61 diopters. The mean FAZ area was 0.3±0.09 mm 2 , the mean SCP-VD was 43.88±3.4%, the mean DCP-VD was 39.6±3.55%, and the mean RPCP-VD was 52.47±3.42%. When the relationship between the OCTA measurements and the SE and AL values were analyzed, there was no statistical significance (p>0.05). When age and OCTA measurements were compared, only DCP-VD values were found to significantly decrease with increasing age (p=0.015). There was no significant difference in OCTA measurements based on gender (p>0.05). Similarly, no statistical age-based differences were observed in RNFLT, CMV and CMT values (p>0.05). Conclusion: With its short procedure time and no dye requirement, OCTA can be safely used in the evaluation of the optic disc and macular perfusion in children. Determination of normative values in children will be useful in detecting pathologic changes in tissue in patients with retinal diseases.

Quantification of macular perfusion in healthy children using optical coherence tomography angiography

“…Unlike previous studies [ 6 – 8 , 18 , 26 ], our research found no correlation between FAZ and CMT. The difference may be attributed to unadjusted results to certain major confounders in previous studies.…”

“…Some research results indicated that adult females had higher FAZ than males, which can also be seen in children as in our study [ 8 , 19 , 23 , 25 , 26 ]. Other studies reported no significant difference between the sexes [ 18 , 25 , 26 ]. In our study, accounting our smaller number of female subjects, the median of FAZ was 0.28 mm (range 0.02–5.05) in male and 0.37 mm (range 0.05–1.08) in female.…”

“…Comparingly, Yilmaz et al reported the SCP-FAZ area to be 0.28 ± 0.09 mm 2 and DCP-FAZ to be 0.38 ± 0.09 in 15 eyes from 15 normal children (a mean age of 8.6 ± 2.2 years- Nidek’s RS-3000 in 3 × 3-mm) [ 17 ]. İçel et al stated SCP-FAZ as 0.3 ± 0.09 mm 2 in 146 children eyes (the mean age of 11.27 ± 3 years- Nidek RS-3000 AngioScan in 3 × 3 mm) [ 18 ]. In our study, the mean FAZ area was 0.44 ± 0.78 mm 2 , considering a single layer measurement on 3 × 3 mm enface image (automatedly derived data from software).…”

“…Similar to our results, Zhang et al showed that in the parafoveal region, the CC had higher vascular flow compared to DCP and SCP ( P < 0.001) [ 8 ]. Some studies have shown that as the FAZ area increases, the VD of SCP, DCP, and CMT decreases dramatically during aging [ 18 ]. In a pediatric study, it is found that CC perfusion density, not retinal VD inversely is correlated with age, even after accounting for potentially confounding factors such as refractive error and race, but not adjusting for sex and the BMI of the children [ 6 ].…”

Normative Data and Determinants of Macular, Disc, and Peripapillary Vascular Density in Healthy Myopic Children Using Optical Coherence Tomography Angiography

“…While the correlation analyzes ( Supplementary Table 1 ) found girls had significantly larger FAZ area than boys and VD at the fovea in the SCP and DCP was significantly greater in boys. This close relationship between FAZ size and sex were greatly consistent with the children studies by İçel et al ( 23 ) and Kiziltoprak et al ( 11 ). The difference in the area and perimeter of FAZ values between different studies may be due to this sex ratio, in addition to different devices, measurement methods, algorithm version, sample size and ethnicity.…”