The Rates of Retinal Nerve Fiber Layer Change in Children With Optic Disc Drusen

Area of Science:

• Ophthalmology
• Neuroscience
• Pediatric Optometry

Background:

• Optic disc drusen (ODD) are calcified deposits in the optic nerve head that can lead to vision loss.
• While often asymptomatic, ODD can cause progressive damage to optic nerve fibers.
• Early identification of structural changes in children with ODD is crucial for managing potential vision impairment.

Purpose of the Study:

• To evaluate the rates of structural changes, specifically retinal nerve fiber layer (RNFL) thinning, in children diagnosed with ODD.
• To identify risk factors associated with accelerated RNFL thinning in pediatric patients with ODD.
• To compare RNFL changes in children with ODD to age-matched glaucoma-suspect controls.

Main Methods:

• A retrospective cohort study design was employed.
• Data from 40 eyes of 22 children with ODD were compared to 40 eyes of 20 glaucoma-suspect children.
• Optical Coherence Tomography (OCT) RNFL tests over a minimum of 18 months were analyzed using linear mixed models.

Main Results:

• Eyes with ODD showed significantly faster rates of RNFL thinning (-2.01 μm/year) compared to the glaucoma-suspect group (-0.07 μm/year).
• Older age at baseline was associated with faster RNFL thinning (0.37 μm/year per year older).
• Higher baseline RNFL thickness was also linked to accelerated thinning (0.07 μm/year per μm increase).

Conclusions:

• Children with ODD exhibit significant RNFL thinning over time.
• Identifying rapid RNFL progression in pediatric ODD is essential for clinical management.
• Understanding these changes aids in distinguishing ODD-related injury from other causes of optic nerve damage.