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S. Krupsky, R. Nesher, N. Geffen, Y. Raz, O. Crystal Shalit, E. Epstein; Evaluation of the Retinal Nerve Fiber Layer in Children With Enlarged Physiological Cupping of the Optic Nerve . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2526.
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to study the thickness of retinal nerve fiber layer (RNFL) in children with enlarged physiological cupping of the optic nerve attempting to identify those with RNFL alterations. Narrowing of RNFL may serve as an indicator of pre–perimetric glaucoma.
Nineteen children diagnosed as having large physiologically cupped discs were referred by their ophthalmologists for this study. All children underwent a comprehensive eye examination. Automated visual field testing (SITA standart, 24–2) was conducted when possible. The control group consisted of 12 children with cup disc ratio of less than 0.5 who underwent similar testing. The nerve fiber layer thickness was evaluated by scanning laser polarimetry (GDx VCC; LDT). The parameters of the study group were compared to those of controls, in addition to automated built in evaluation in reference to the closest age group (above 18) provided by the machine's software.
Children 5–18 years old were included in the study group. Ten children (20 eyes) were able to perform visual field test, of which 17 were reliable. All visual fields were normal. Average thickness parameters were lower in children with enlarged cupping while the disc vertical diameter was higher. Nerve fiber indicator was normal but higher in the study group.
Lower RNFL thickness is associated with enlarged cupping as well as larger vertical disc diameter. Wider spread of the nerve fibers around the disc could account for this finding and should be differentiated from pathological thinning of the RNFL. RNFL thickness may play a role in the evaluation of children with enlarged cupping. .
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