A Comparison of Glaucoma Testing Strategies in Pediatric and Adult Subjects using OCT3.

Abstract

Abstract: : Purpose: To determine the viability of using Optical Coherence Tomography in pediatric subjects and to perform a cross–sectional comparison of glaucoma testing strategies in pediatric and adult subjects using OCT3000 (OCT3). Methods:Subjects were divided into two age groups: 8–17, 18 and older. Inclusion criteria were: subjects had to be at least 8 years of age, best–corrected visual acuity had to be at least 5/200E. Subjects with corneal, retinal, or optic nerve head disease were excluded. All subjects were given a complete dilated eye exam followed by OCT3 scans of the nerve fiber layer (NFL), macula, and optic nerve head. All results were compared in a blinded statistical analysis. Comparisons were made between the pediatric and adult groups. Racial analyses within the respective groups were also performed. Results: 128 eyes of 64 subjects between the ages of 8 and 81 were evaluated (36 adults, 28 children). The pediatric subjects were found to have a thicker NFL (103.8 ± 11.5µm vs. 97.2 ± 13.0µm, p = 0.003) and increased macular volume (6.906 ± 0.302mm³ vs. 6.715 ± 0.364mm³, p = 0.002) compared to adult subjects. Separate analyses within the adult and pediatric goups revealed that African American adults had a thicker NFL than Caucasian adults (105.6 ± 9.8µm vs. 93 ± 12.4µm, p < 0.001), and African American children had a larger cup–disc ratio than Caucasian children (0.239 ± 0.098 vs. 0.122 ± 0.120, p < 0.001). Macular volume was not significantly different between races (peds: p = 0.323; adults: p = 0.353). Rim area was not significantly different between the pediatric and adult groups (1.491 ± 0.768mm² vs. 1.472 ± 0.634mm², p = 0.846) or between races (peds: p = 0.909; adults: p = 0.534). Conclusions: OCT is a viable technology for the pediatric population and may be useful in evaluating diseases such as pediatric glaucoma. The NFL appears to become thinner and macular volume appears to decrease with increasing age. African American adults appear to have a significantly thicker NFL than Caucasian adults. African American children appear to have a significantly larger cup–disc ratio than Caucasian children.

Keywords: nerve fiber layer • macula/fovea • aging