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Optical Coherence Tomography Normative Peripapillary Retinal Nerve Fiber Layer and Macular Data in Children 0-5 Years
Jill C Rotruck1, Robert J House2, Sharon F Freedman2
1Duke University Department of Ophthalmology, Durham, North Carolina, USA; Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, Connecticut, USA.
Insights
Peripapillary retinal nerve fiber layer thickness is stable in young children. Macular volume and retinal layer development show age-related changes in children aged 0-5 years.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Retinal Imaging
Background:
- Establishing normative data for ocular structures in children is crucial for early detection of disease.
- The peripapillary retinal nerve fiber layer (pRNFL) and macula are key indicators of optic nerve health and visual development.
Purpose of the Study:
- To determine reference values for the peripapillary retinal nerve fiber layer (pRNFL) and macula in healthy children aged 0-5 years.
- To investigate age-related changes in these ocular structures during early childhood.
Main Methods:
- A prospective cross-sectional study was conducted involving healthy children aged 0 to <6 years undergoing surgery.
- Optical Coherence Tomography (OCT) scans of the optic nerve and retina were acquired under general anesthesia.
- Automated segmentation with manual correction was used to analyze pRNFL and retinal layer volumes.
Main Results:
- Mean global pRNFL thickness was 107.6 ± 10.3 μm and showed no age dependency but a negative relationship with axial length.
- Mean total macular volume was 8.56 ± 0.259 mm³ in a subset of participants, with no relationship to age.
- While pRNFL thickness remained stable, macular volume and specific retinal layers (ganglion cell layer, inner nuclear layer) showed age-related development, with photoreceptor layers increasing logarithmically with age.
Conclusions:
- Global pRNFL thickness measurements are stable in children aged 0-5 years.
- Macular volume and retinal layer thicknesses demonstrate development and maturation with age in early childhood.
- These findings provide essential normative data for pediatric ophthalmology.
Purpose:
To determine reference values for the peripapillary retinal nerve fiber layer (pRNFL) and macula in children 0-5 years of age.
Design:
Prospective cross-sectional study.
Methods:
This study was set in a single large academic pediatric ophthalmology practice. Healthy, full-term children 0 to <6 years of age presenting for surgery under general anesthesia were prospectively recruited for participation. Excluded were children with systemic neurologic disease, optic nerve or retinal disease (even if unilateral) or any bilateral ocular disease process, and eyes with amblyopia, ocular disease, or spherical equivalent refractive error outside of -3.00 to +8.00 diopters. Following general anesthesia, OCT scans of the optic nerve and retina were acquired using an HRA+OCT Spectralis with Flex module (Heidelberg Engineering). Automated segmentation of the pRNFL and retinal layers was followed by manual correction.
Results:
Data were obtained from normal eyes of 57 participants (mean age 2.28 ± 1.50 years). Mean global pRNFL thickness was 107.6 ± 10.3 μm. Mean global pRNFL thickness was not dependent on age but showed a negative relationship with axial length (P = .01). The mean total macular volume was 8.56 ± 0.259 mm3 (n = 38). No relationship was found between total macular volume and age. Ganglion cell layer, ganglion cell complex, and inner nuclear layer volumes showed an inverse relationship with age while the photoreceptor layers showed a logarithmic increase with age.
Conclusions:
Global pRNFL thickness measurements remain stable over time. Macular volume and thickness values of segmented retinal layers reflect the development of the macula with age.
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