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Changes of Peripapillary Retinal Nerve Fiber Layer in Childhood Glaucoma: A Systematic Review and Meta-Analysis

Yuwen Wen1, Yingting Zhu1, Yehong Zhuo1

  • 1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

Frontiers in Medicine
|October 28, 2021
PubMed

Insights

Childhood glaucoma is associated with thinning in all eight retinal nerve fiber layer (RNFL) quadrants. This systematic review highlights varying degrees of reduction across these regions in pediatric glaucoma patients.

Area of Science:

  • Ophthalmology
  • Pediatric Glaucoma Research
  • Retinal Imaging Analysis

Background:

  • Childhood glaucoma presents with alterations in retinal nerve fiber layer (RNFL) thickness, but specific thinning patterns remain unclear.
  • Understanding RNFL characteristics in pediatric glaucoma is crucial for elucidating neuropathic mechanisms.
  • Inconsistent findings necessitate further exploration of RNFL thinning in different quadrants.

Approach:

  • A systematic literature review was performed using major biomedical databases (Cochrane, Medline, Embase, PubMed).
  • Studies published up to April 1, 2021, focusing on pediatric glaucoma and RNFL thickness were included.
  • Ten studies comprising 311 children with glaucoma and 444 controls were analyzed.

Key Points:

  • Average peripapillary RNFL (pRNFL) thickness was significantly reduced in pediatric glaucoma patients (WMD = -20.75, p < 0.00001).
  • RNFL thickness reduction was observed across all eight measured quadrants (superior, inferior, temporal, nasal, and their combinations).
  • The degree of pRNFL thinning varied among the eight quadrants in the pediatric glaucoma cohort.

Conclusions:

  • Childhood glaucoma is characterized by thinning in all eight RNFL quadrants, with differential degrees of reduction.
  • Heterogeneity among the reviewed studies warrants caution in interpreting the findings.
  • Larger, multicenter studies are recommended to validate these results and refine understanding of RNFL changes in pediatric glaucoma.

Keywords:
childhood glaucomaglaucoma optic nerve damagemeta-analysisretinal nerve fiber layer (RNFL) thicknessspectral-domain optical coherence tomography (SD-OCT)

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