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Inae Jang, Lindsay Machen, Dingcai Cao, Cem Mocan; Relationship between refractive error and peripapillary retinal nerve fiber layer thickness in pediatric glaucoma suspects.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5517. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
There is limited data on the association between refractive error and the peripapillary retinal nerve fiber layer (RNFL) thickness in pediatric glaucoma suspects with large optic nerve cup-to-disc ratios (CDR). The purpose of this study was to evaluate the relationship between refractive error and retinal nerve layer (RNFL) thickness in pediatric glaucoma suspects.
Clinical records of pediatric glaucoma suspects at a single academic institution were reviewed retrospectively. Glaucoma suspect status was defined by optic nerve cup-to disc ratio (CDR) of ≥ 0.5 in each eye. Patients with a prior history of intraocular surgery were excluded. RNFL thickness of all subjects was measured using a spectral-domain optical coherence tomography (OCT) (Spectralis® OCT, Heidelberg Engineering). Average and sectorial RNFL thickness measurements, CDRs, intraocular pressure (IOP) and refractive error (RE) in spherical equivalents were obtained for each eye. Mean values of two eyes were used in data analysis for all subjects. Generalized estimation equation models, which can account between-eye correlations, were used to assess the relationship between CDR and RNFL thickness as well as refractive error and RNFL thickness.
Twenty-one subjects (9F/12M) with a mean age of 9.5±3.1 years (range= 5-15 years) were included in the study. Study patients were of Hispanic (n=11; 53.4%), African-American (n=5; 23.8%), Asian (n=2; 9.5%), Caucasian (n=1; 4.8%) and undetermined (n=2; 9.5%) backgrounds. The mean CDR and IOP were determined as 0.69±0.05 and 16.6±3.0 mmHg, respectively. Overall, there was no significant association between CDR and mean RNFL thickness (beta(se)=-0.0003 (0.001); p=0.757). Refractive error was found to be directly associated with average RNFL thickness [beta(se)= 0.0712 (0.0298); p=0.017) and temporal RNFL thickness (beta(se) = 0.0281(0.0148), p=0.057).
Refractive error, but not increased CDR, is associated RNFL thickness measurements in pediatric glaucoma suspects with large CDRs. Refractive status should be taken into consideration when interpreting the RNFL layer thickness in this patient population.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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