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Values of peripapillary retinal nerve fibre layer thickness are different in children and adults

Alicia Muñoz-Gallego1, José L Torres-Peña1, Martín Rodríguez-Salgado2

  • 1Ophthalmology Department, Madrid University Complutense, Madrid, Spain.

Clinical & Experimental Optometry
|July 18, 2024
PubMed

Insights

Using adult optical coherence tomography (OCT) databases for pediatric peripapillary nerve fibre layer (pRNFL) thickness can lead to misdiagnosis. New pediatric reference values are crucial for accurate detection of optic nerve disease in children.

Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Pediatric Optometry

Background:

  • Accurate measurement of peripapillary nerve fibre layer (pRNFL) thickness using optical coherence tomography (OCT) is vital for diagnosing optic nerve diseases in children.
  • Current OCT devices often rely on adult reference databases, potentially leading to inaccurate assessments in pediatric populations.

Purpose of the Study:

  • To assess the agreement between adult and pediatric reference databases for pRNFL thickness measurements in children.
  • To establish normative reference values for pRNFL thickness in the pediatric population, considering spherical equivalent.

Main Methods:

  • A cross-sectional study involving 126 healthy children.
  • pRNFL thickness was measured using the Topcon 3D OCT 2000 device.
  • Comparison of measurements against both adult and a newly established pediatric reference database.

Main Results:

  • Significant discrepancies were observed when applying adult reference values to pediatric pRNFL measurements.
  • A substantial percentage of pediatric values fell outside the normal range based on adult data but were normal using pediatric data.
  • Specifically, adult thresholds misclassified 6.6% (quadrants) and 19.3% (sectors) of normal pediatric pRNFL values as abnormal, and 88% (quadrants) and 72% (sectors) of abnormal pediatric values as normal.

Conclusions:

  • Adult reference databases are inadequate for interpreting pediatric pRNFL thickness measurements from OCT scans.
  • Employing normative pediatric databases is essential to avoid misclassification and ensure accurate diagnosis of optic nerve conditions in children.
Abstract

Keywords:
Childrenoptic nerveoptical coherence tomographyperipapillary nerve fibre layer

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