Abstract
Purpose :
To evaluate the degree of agreement between different methods for assessing cup-to-disc ratio (CDR) in a pediatric glaucoma suspect population.
Methods :
This was retrospective study undertaken at a single academic center. The medical records of patients ≤14 years of age with a diagnosis of glaucoma suspect based on large (≥0.5) CDRs were screened for visual acuity, intraocular pressure, central corneal thickness, and anterior segment and dilated fundus exams. CDR was graded by: i) indirect ophthalmoscopy (IO) by a pediatric ophthalmologist; ii) optic nerve 30-degree digital fundus images (D30); and iii) spectral domain optical coherence tomography (SD-OCT, Heidelberg Spectralis). We evaluated agreement in CDR measurements between IO or D30 vs. SD-OCT.
Results :
A total of 38 patients (24M/14F) (60 eyes) were included in the analysis. Mean age at presentation was 9.14±3.06 years (range 2-14 years). All patients underwent OCT imaging between ages 5-15 years. The mean CDRs were 0.66±0.10, 0.66±0.03, and 0.632±0.05 assessed by IO, D30, and SD-OCT, respectively. Agreement analysis between IO and SD-OCT disclosed a mean difference (±SE) of 0.02±0.01 (Wilcoxon Signed Rank test p = .001). Analysis between D30 and OCT disclosed a mean difference (± SE) of 0.03±0.00 (Wilcoxon Signed Rank test p < .001). The mean coefficient of variability was 12.35±8.86% and 8.57±6.43% when comparing IO and D30 to SD-OCT, respectively.
Conclusions :
Agreement analysis indicates that CDR measurement by optic nerve digital images renders comparable results to optic nerve SD-OCT. Digital optic nerve images can be used to assess CDR measurement in pediatric glaucoma suspects.
This is a 2020 ARVO Annual Meeting abstract.