Abstract
Purpose :
In our review of myopic children, we occasionally encounter children with large cup-disc ratios (CDRs) and there is concern that the child may have concurrent glaucoma which may have induced myopia progression. The aim of this study is to determine characteristics of these optic discs.
Methods :
In the PROM-Kids myopia cohort, including children aged 7-16 years presenting to a myopic clinic in Singapore, right-eye baseline optic disc characteristics of the first 700 children were analysed. Optic disc CDRs were assessed clinically, and divided into 3 groups with CDRs of (A) 0.00-0.39, (B) 0.40-0.59, and (C) 0.60-0.90. Demographic, biomettic and OCT characteristics in each of these groups were analysed.
Results :
The majority of children were in Gp A (n375, 54%) and B (n274, 39%). Only 51 (7%) in had a CDR>0.6D (Gp C). There were no significant differences in age, race, gender and spherical equivalent (SE) between groups. Children with smaller CDR (Gp A) had shorter axial lengths (AL) (24.9+/-1.1 vs 25.2+/-1.1mm, p=0.0160) than in Gp B; and lower intraocular pressures (IOP) (17.1+/-2.5 vs 18.0+/-2.3mmHg, p=0.025) than in Gp C. Children in Gp A had smaller disc areas (1.86+/-0.39 vs 2.25+/-0.39mm2, p<0.001) and rim areas (1.58+/-0.42 vs 1.08+/-0.26mm2, P<0.001) than children in Gp C, and thicker peripapillary retina nerve fibre layer (RNFL) thickness in the superior, inferior and temporal quadrants then those in Gp B. 567 and 204 children had repeat OCT 1 and 2 years later, respectively. In these children, there was no/little change in RNFL thickness in all 3 groups over time.
Conclusions :
The presence of a larger disc areas, IOP and OCT peripapillary RNFL thickness within reasonably normal limits, and a lack of change in peripapillary RNFL thickness over time may help exclude glaucoma in children presenting with large CDRs.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.