Abstract
Purpose :
The association between optic nerve cup to disc ratio (CDR) and peripapillary retinal nerve fiber layer (RNFL) thickness in pediatric glaucoma suspects is largely undetermined. The purpose of the study was to evaluate the relationship between RNFL thickness, CDR and intraocular pressure (IOP) in pediatric glaucoma suspects.
Methods :
Retrospective study undertaken at a single university outpatient clinic setting. Clinical records of pediatric glaucoma suspects between the ages of 1-16 years were reviewed. Glaucoma suspect status was defined by a CDR ≥ 0.5 in at least one eye. Patients with a prior history of intraocular surgery were excluded. Variables including IOP, CDR, central corneal thickness (CCT), optic nerve head findings and average RNFL thickness as measured by ocular coherence tomography (OCT) were recorded. Statistical evaluations were performed using Pearson correlation analysis and the student T-test.
Results :
Twenty-eight patients (16 M/12 F) with a mean age of 9.6±3.7 years were included in the study; all subjects had OCT performed during the course of their care. Study sample included patients from Hispanic (n=14; 50%), African-American (n=7; 25%), Caucasian (n=4; 14%), Asian (n=1; 4%), and unknown (n=2; 7%) racial backgrounds. No subjects had identified neurologic diagnoses or developmental delay. The mean CDR in the right and the left eyes was 0.66±0.12 and 0.66±0.09, respectively. The mean RNFL thickness was not significantly different between the right and the left eyes (94.43±11.68 µm vs. 96.25±10.45 µm; p=0.211). The mean IOP was 16.9±3.41 mmHg in the right and 16.1±3.59 mm Hg in the left eyes of subjects (range=10.0 to 23.5 mmHg). A significant correlation between RNFL thickness and CDR was not observed for the right (r=-0.256, p=0.189) or the left (r=-0.180, p=0.361) eye measurements. Average RNFL thickness did not correlate with IOP in either eye of subjects (r=0.043, p=0.955 OD; r=-0.076, p=0.702 OS).
Conclusions :
In pediatric glaucoma suspects with enlarged CDR, and without significant IOP elevation, average RNFL thickness does not correlate with CDR or IOP. Our findings suggest that increased optic nerve cupping in pediatric glaucoma suspects is not associated with retinal nerve fiber layer loss.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.