Longitudinal reproducibility of optical coherence tomography measurements in children

Abstract

Purpose-To evaluate the longitudinal reproducibility of optical coherence tomography (OCT) measurements in normal and glaucomatous eyes of children.Methods-In this two-setting prospective study, OCT-3 was used to obtain fast retinal nerve fiber layer (RNFL) and of 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" (elevated IOP and a normal optic nerve appearance); or "advanced glaucoma,"(severe cupping or progressive glaucoma). Intraclass correlation coefficients (ICC) 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. ICCs across the three visits for total macular volume were 0.80-0.91 and for average RNFL were 0.73-0.95. Conclusions-GlobalOCT 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.Monitoring children with known or suspected glaucoma often poses a challenge to the clinician due to the difficulty of obtaining reliable visual fields and other objective measures of disease progression or stability. Optical coherence tomography (OCT) is a fast, noninvasive imaging technology that can measure the retinal nerve fiber layer (RNFL) Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. OCT measurements of RNFL and macular thickness differ in normal and glaucomatous eyes of children. 5 OCT measurements of both RNFL and macular thickness have also been shown to correlate negatively with increasing grade of glaucomatous damage seen on optic nerve head stereophotographs. 6 In order for OCT to be useful in monitoring children with glaucoma for disease progression, it must be reproducible over time despite normal axial length growth. Previous studies have shown that in healthy eyes of children, OCT measurements of macular and RNFL thickness are reproducible within the same day 7 ; however...

Reproducibility of circumpapillary retinal nerve fiber layer measurements using handheld optical coherence tomography in sedated children

“…9,11,12 Prakalapakorn and colleagues performed one of the only longitudinal studies of circumpapillary RNFL thickness in children with glaucoma using time-domain OCT, which demonstrated CVs somewhat comparable to our study. 29 While our results can be used to plan future handheld OCT studies in children with optic pathway gliomas, our results may not be applicable to children with other optic neuropathies (i.e., glaucoma, optic neuritis), as their pattern of RNFL loss and mechanism of damage are different.…”

“…29 The ophthalmologic monitoring and neuro-oncologic care of children with optic pathway gliomas, especially those with NF1-related optic pathway gliomas, is challenging for a number of reasons. First, since optic pathway gliomas typically occur in toddlers and very young children, a group known to have a low rate of success in completing recognition VA testing 30 and manual/automated perimetry, circumpapillary RNFL thickness could serve as a surrogate marker of pregeniculate visual pathway integrity.…”

Corneal Biomechanics, Retinal Nerve Fiber Layer, and Optic Disc in Children

“…The OCT technique 12,17,26 and its reproducibility in children 27,28 have already been described in several reports. An optic disc cube 200 Â 200 protocol was used to obtain the RNFL thickness and ONH measurements.…”

Optical coherence tomography in the management of congenital glaucoma

“…We know that normative values for these OCT parameters vary with age, race and axial length 10. Reproducibility studies are scarce11 12 and we still do not know the longitudinal reproducibility of spectral domain OCT values in a growing child 11 12…”

“…Second, given that OCT values correlate with axial length, we expect that the longitudinal reproducibility of OCT in the eyes of growing children would be affected by axial growth. One study found that the difference that would be engendered by axial length growth in a growing child is negligible since it would be less than the test–retest variance of the time domain OCT machine 12. However, SD-OCT has been reported to have better reproducibility than time domain OCT in both adults and children,11 so one would expect that a change in axial length will affect SD OCT values.…”