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Optic Nerve Head Development in Healthy Infants and Children Using Handheld Spectral-Domain Optical Coherence Tomography

View Article: PubMed Central - PubMed

ABSTRACT

Purpose: To determine feasibility of optic nerve head (ONH) imaging and to characterize ONH development in full-term infants without sedation using handheld spectral-domain optical coherence tomography (SD OCT).

Design: Prospective cross-sectional study.

Participants: Three hundred fifty-two children aged between 1 day and 13 years.

Methods: All participants were imaged using handheld SD OCT without sedation during a single scan session. The percentage of successful scans was calculated. Interexaminer reproducibility and differences between right and left eyes were assessed using intraclass correlation coefficients (ICCs). Images were analyzed using ImageJ software. The developmental trajectories over time for ONH parameters were calculated using fractional polynomial modelling.

Main outcome measures: Disc and cup diameter (expressed as distance in micrometers and visual angle in degrees), cup depth, Bruch's membrane opening–minimum rim width (BMO-MRW), retinal thickness, and retinal nerve fiber layer (RNFL; 1700 μm and 6° from the disc center).

Results: On average, 70% of participants were imaged successfully. Interexaminer reliability was excellent (ICC, >0.89) for diametric and retinal thickness parameters. Right and left eyes were similar for diametric measurements (ICC, >0.79), but more variable for nasal BMO-MRW, RNFL, and retinal thickness. The mean disc and cup diameter increase by 30% and 40%, respectively, between birth and 13 years of age when expressed as a distance measure, but remained constant (at 5°–5.5° and 2°, respectively) when expressed as a visual angle with reference to the eye nodal point. The peripapillary temporal RNFL demonstrated a marked initial decrease of nearly 35% between birth and approximately 18 months of age. This was followed by a slow increase up to 12 years of age when measured at 1700 μm from the disc center, although there was little change when measured at 6° from the disc center.

Conclusions: We demonstrated feasibility of handheld SD OCT imaging of the ONH in full-term infants and children without anaesthesia or sedation. This is the first in vivo handheld SD OCT study to describe the development of ONH parameters during the critical early years of visual maturation. Our results provide a normative database for use in routine practice and further studies of ONH pathologic features.

No MeSH data available.


Scatterplots demonstrating the change of (A) temporal retinal nerve fiber layer (RNFL) measured at 1.7 mm from the disc center, (B) temporal RNFL measured at 6.0° from the disc center, (C) nasal RNFL measured at 1.7 mm from the disc center, and (D) nasal RNFL measured at 6.0° from the disc center with age (in months). Mean values (black line), 95% confidence intervals of the mean (grey line), and prediction interval (dashed line) are highlighted.
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fig5: Scatterplots demonstrating the change of (A) temporal retinal nerve fiber layer (RNFL) measured at 1.7 mm from the disc center, (B) temporal RNFL measured at 6.0° from the disc center, (C) nasal RNFL measured at 1.7 mm from the disc center, and (D) nasal RNFL measured at 6.0° from the disc center with age (in months). Mean values (black line), 95% confidence intervals of the mean (grey line), and prediction interval (dashed line) are highlighted.

Mentions: In contrast to the temporal rim, the temporal RNFL demonstrated a marked initial decrease of approximately 33% between birth and approximately 18 months of age (from a mean of 70 μm to 46 μm). When measured at a fixed distance of 1.7 mm from the disc center, this was followed by a slow increase up to 13 years of age (an increase of 22% up to 55 μm; Fig 5A; Table 4). However, when measuring temporal RNFL thickness at a fixed visual angle of 6° from the disc center (Fig 5B), after the initial decrease, the RNFL thickness remained constant at approximately 55 μm. The nasal RNFL did not change significantly when measured at a fixed distance of 1.7 mm (F = 2.77; P = 0.10; Fig 5C; Table 4) or a fixed angle of 6° (F = 1.95; P = 0.17; Fig 5D).


Optic Nerve Head Development in Healthy Infants and Children Using Handheld Spectral-Domain Optical Coherence Tomography
Scatterplots demonstrating the change of (A) temporal retinal nerve fiber layer (RNFL) measured at 1.7 mm from the disc center, (B) temporal RNFL measured at 6.0° from the disc center, (C) nasal RNFL measured at 1.7 mm from the disc center, and (D) nasal RNFL measured at 6.0° from the disc center with age (in months). Mean values (black line), 95% confidence intervals of the mean (grey line), and prediction interval (dashed line) are highlighted.
© Copyright Policy - CC BY
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036922&req=5

fig5: Scatterplots demonstrating the change of (A) temporal retinal nerve fiber layer (RNFL) measured at 1.7 mm from the disc center, (B) temporal RNFL measured at 6.0° from the disc center, (C) nasal RNFL measured at 1.7 mm from the disc center, and (D) nasal RNFL measured at 6.0° from the disc center with age (in months). Mean values (black line), 95% confidence intervals of the mean (grey line), and prediction interval (dashed line) are highlighted.
Mentions: In contrast to the temporal rim, the temporal RNFL demonstrated a marked initial decrease of approximately 33% between birth and approximately 18 months of age (from a mean of 70 μm to 46 μm). When measured at a fixed distance of 1.7 mm from the disc center, this was followed by a slow increase up to 13 years of age (an increase of 22% up to 55 μm; Fig 5A; Table 4). However, when measuring temporal RNFL thickness at a fixed visual angle of 6° from the disc center (Fig 5B), after the initial decrease, the RNFL thickness remained constant at approximately 55 μm. The nasal RNFL did not change significantly when measured at a fixed distance of 1.7 mm (F = 2.77; P = 0.10; Fig 5C; Table 4) or a fixed angle of 6° (F = 1.95; P = 0.17; Fig 5D).

View Article: PubMed Central - PubMed

ABSTRACT

Purpose: To determine feasibility of optic nerve head (ONH) imaging and to characterize ONH development in full-term infants without sedation using handheld spectral-domain optical coherence tomography (SD OCT).

Design: Prospective cross-sectional study.

Participants: Three hundred fifty-two children aged between 1 day and 13 years.

Methods: All participants were imaged using handheld SD OCT without sedation during a single scan session. The percentage of successful scans was calculated. Interexaminer reproducibility and differences between right and left eyes were assessed using intraclass correlation coefficients (ICCs). Images were analyzed using ImageJ software. The developmental trajectories over time for ONH parameters were calculated using fractional polynomial modelling.

Main outcome measures: Disc and cup diameter (expressed as distance in micrometers and visual angle in degrees), cup depth, Bruch's membrane opening–minimum rim width (BMO-MRW), retinal thickness, and retinal nerve fiber layer (RNFL; 1700 μm and 6° from the disc center).

Results: On average, 70% of participants were imaged successfully. Interexaminer reliability was excellent (ICC, >0.89) for diametric and retinal thickness parameters. Right and left eyes were similar for diametric measurements (ICC, >0.79), but more variable for nasal BMO-MRW, RNFL, and retinal thickness. The mean disc and cup diameter increase by 30% and 40%, respectively, between birth and 13 years of age when expressed as a distance measure, but remained constant (at 5°–5.5° and 2°, respectively) when expressed as a visual angle with reference to the eye nodal point. The peripapillary temporal RNFL demonstrated a marked initial decrease of nearly 35% between birth and approximately 18 months of age. This was followed by a slow increase up to 12 years of age when measured at 1700 μm from the disc center, although there was little change when measured at 6° from the disc center.

Conclusions: We demonstrated feasibility of handheld SD OCT imaging of the ONH in full-term infants and children without anaesthesia or sedation. This is the first in vivo handheld SD OCT study to describe the development of ONH parameters during the critical early years of visual maturation. Our results provide a normative database for use in routine practice and further studies of ONH pathologic features.

No MeSH data available.