Abstract
Abstract: :
Purpose: This study investigates the thickness of the retinal nerve fiber layer in a pediatric population to develop a normative database, and as an indication of otherwise undiagnosed optic nerve disease in children. Methods: The NFA/GDx was used to measure Nerve Fiber Layer (NFL) thickness. We studied 100 healthy children from 4 to 17 years of age. A comprehensive ophthalmic examination included best-corrected visual acuity of 20/20 in each eye, slit lamp biomicroscopy, dilated fundus exam and cover testing. The nerve fiber analysis was performed thereafter in an undilated state and only the right eyes were tested in order to obtained the purest data. Polarimetric data analysis was performed in two children with optic atrophy and patterns were compared with the NFL analysis in normal children. Results: The mean peripapillary NFL in the right eye measured in microns is 104 (SD=19), 93 (SD=19), 50 (SD=15), 37 (SD=11), in the superior, inferior, temporal, and nasal quadrants, respectively. Numerous other parameters were determined during the study. Figures 1-4 illustrate a NFL analysis of the right eye of healthy children. Figures 5-6 show the NFL analysis in two children with optic nerve atrophy for comparison. Conclusion: In children with normal eyes, the NFL is greatest in the superior and inferior quadrants and thinnest temporally and nasally. This gives the characteristic "double hump" pattern on the thickness curve very similar to adults. The children who had optic atrophy had a flat waveform. The NFA/GDx is a valuable tool in helping to assess a variety of optic nerve diseases in children now that a normal database has been established.
Keywords: 487 neuro-ophthalmology: optic nerve • 498 optic disc • 350 clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology