Retinal and Optic Nerve Head Imaging in Children

Abstract

Purpose : Myopia development typically begins in childhood. Evaluating posterior ocular structures in children may provide insight into the mechanisms of ocular growth, refractive development, and myopia progression. The aims of this study were to evaluate retinal, choroidal and optic nerve head (ONH) parameters in children.

Methods : Healthy children, aged 11.15 ± 2.62 years (range 6-15 years, n=54) underwent a vision screening followed by dilation, autorefraction, and spectral domain optical coherence tomography (SD-OCT) imaging in both eyes. SD-OCT scans included a 12° peripapillary circular scan, a 20° 24 line radial scan centered on the ONH and a macular volume scan (20°x20°, 97 line). Scans were laterally scaled using biometric data collected from each eye and a 4-surface schematic eye modified for children. Quantification of retinal and choroidal thicknesses, peripapillary nerve fiber layer (NFL) thickness, Bruch’s membrane opening (BMO) area, minimum rim width (MRW), and anterior lamina cribrosa surface depth (ALCSD) was performed with a custom Matlab program, and analyzed with age, refraction, and axial length.

Results : Axial length increased and refraction decreased with age (r²=0.31, p<0.0001, and r²=0.31, p<0.0001, respectively). Peripapillary NFL thickness decreased by 0.98 µm per year of life (p=0.08), reaching significance for the superior retina (p<0.01). Peripapillary NFL thickness decreased with increasing axial length (r²=0.14, p<0.01), decreasing subfoveal choroidal thickness (r²=0.16, p<0.01), and increasing myopic refraction (r²=0.12, p<0.05). Peripapillary retinal thickness decreased with axial length (r²=0.17, p<0.01) and increased with foveal retinal thickness (r²=0.085, p=0.05), but was not associated with age or refraction. Disc area increased with myopic refraction (r²=0.12, p<0.05). Subfoveal choroidal thickness (328.88 ± 78.69 µm) and ALCSD (370.76 ± 84.45 µm) were not associated with age, refraction, or axial length.

Conclusions : Findings show that axial length increases and refraction decreases with age in children. Disc area and NFL thickness were associated with refraction. Consistent with previous cross sectional studies in adults, NFL showed a trend of age-related thinning. Other posterior ocular structures, including BMO area, MRW, choroidal thickness and ALCSD, were similar across age and refraction.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.