A prospective study on 71 children to investigate normative pediatric values in optical coherence tomography

Aims: Optical coherence tomography (OCT) is a noninvasive radiation-free method for imaging retinal structures and measuring retinal nerve fiber layer (RNFL) thickness and total macular volume (TMV). Newer devices even allow segmentation of all retinal layers and individualized follow-up comparisons.

So far, normative values for this potential diagnostic tool in pediatric populations are widely lacking.

The aim of this study is to investigate normal values in a healthy pediatric population for peripapillary RNFL, TMV, and layer segmentation in OCT.

Methods: The study was approved by the responsible ethics committee and informed consent was obtained from all parents before any study procedure was initiated.

A prospective study was performed to measure peripapillary RNFL thickness, TMV, and all retinal layers via spectral-domain OCT (Spectralis; Heidelberg Engineering, Heidelberg, Germany).

Medical history was assessed for coexisting ophthalmologic, neurologic, and other potentially confounding disorders, concomitant medication, and preterm birth.

Results: A total of 71 children aged 4 to 16 years were enrolled in the study. Three children had to be excluded due to preterm birth (n = 2) or severe myopia (n = 1).

All OCT measurements were analyzed for sufficient quality. Values of peripapillary RNFL thickness were therefore included from 64 left and 59 right eyes and showed a mean (SD) global RNFL of 102.1 (8.367)µm (left: 101.4 (8.368)µm; right: 102.8 (8.382)µm; p = ns). Influences of gender and age have been investigated. TMV and layer segmentation are currently being evaluated under an experimental setting with results still pending.

Conclusion: OCT may serve as a complementary tool in diagnosis and evaluation of different pediatric neurological and ophthalmologic disorders as it is feasible and safe. With the establishment of pediatric normal values in relation to gender and age, more targeted interpretation of findings will be possible. However, larger studies should be performed to confirm our results.