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Dr Patel, Ravi Purohit, Helena Lee, Viral Sheth, Gail Maconachie, Eleni Papageorgiou, Frank A Proudlock, Rebecca J McLean, Irene Gottlob; Characteristics of Normal Optic Nerve Development Using Hand-Held Ultra-High Resolution Spectral Domain Optical Coherence Tomography in Children and Young Adults.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6235.
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Early development of the optic nerve has previously been limited to histology and fundus photography. This is the first study to characterise optic nerve morphology in healthy full term infants and young adults using ultra-high resolution spectral domain hand-held OCT (HH SD-OCT).
178 infants and young adults aged between 1 day and 18 years of age were recruited to the study. All participants were over 37 weeks gestational age at birth with no known ocular or neurological concerns. Full ophthalmological examination and a HH SD-OCT scan (Bioptigen, 2.6µm axial resolution) were performed without sedation. Images were analysed using ImageJ software with the assessor masked. Optic nerve cup, disc and neuroretinal rim parameters along with peripapillary retinal thickness and retinal nerve fibre layer (RNFL) were quantified and correlated with log gestational age (logGA).
The optic disc and cup diameters and areas increased linearly with logGA (p<0.001) with the result that cup / disc ratios of diameters did not significantly change with logGA (p=0.08). Nasal and temporal neuroretinal rim areas and nasal peripapillary RNFL also increased linearly with logGA (p=0.04, p=0.01 and p=0.08 respectively). In contrast temporal peripapillary RNFL demonstrated a marked initial decrease in thickness between birth and 90 weeks gestational age followed by a slow increase. Change in peripapillary retinal thickness was also linear (p<0.001).
This is the first study to describe optic nerve development of full-term infants and children using HH SD-OCT. We have demonstrated the temporal RNFL has a different course of development to other optic nerve parameters. Our results provide a normative database for further studies investigating optic nerve pathology.
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