Retinal nerve fiber layer thickness in children with primary congenital glaucoma measured by spectral domain optical coherence tomography

Perucho-González, L.; Martinez-de-la-Casa, José M.; Sáenz-Francés, F.; Morales-Fernández, Laura; Méndez-Hernández, Carmen; Sánchez-Jean, Rubén; García‐Feijoó, Julián

doi:10.1016/j.jaapos.2017.03.023

Cited by 8 publications

(9 citation statements)

References 23 publications

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“…In the present study, the observation of SD-OCT measurements of 72 children (19 with paediatric glaucoma, 59 healthy controls) as young as 6 years of age, reveals a significantly reduced pRNFL thickness in glaucoma patients compared to the healthy controls. This is in line with previous results on adults [28] and children [8,29].…”

Section: Discussionsupporting

confidence: 94%

The Paediatric Glaucoma Diagnostic Ability of Optical Coherence Tomography: A Comparison of Macular Segmentation and Peripapillary Retinal Nerve Fibre Layer Thickness

Lever

Halfwassen

Unterlauft

et al. 2021

Biology

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Paediatric glaucoma leads to a decreased thickness of the peripapillary retinal nerve fibre layer (pRNFL) and of the macula. These changes can be precisely quantified using spectral domain-optical coherence tomography (SD-OCT). Despite abundant reports in adults, studies on the diagnostic capacity of macular SD-OCT in paediatric glaucoma are rare. The aim of this study was to compare the glaucoma discriminative ability of pRNFL and macular segment thickness in paediatric glaucoma patients and healthy children. Data of 72 children aged 5–17 years (glaucoma: 19 (26.4%), healthy: 53 (73.6%)) examined with SD-OCT (SPECTRALIS®, Heidelberg Engineering) were analysed retrospectively. The thickness of pRNFL sectors and of macular segment subfields were compared between diseased and healthy participants. Areas under the receiver-operating characteristic curves (AUC), sensitivity, and specificity from logistic regression were used to evaluate the glaucoma discriminative capacity of single and combined pRNFL and macular segments’ thickness. The results revealed a reduced thickness of the pRNFL and of the three inner macular layers in glaucoma patients, which correlates highly with the presence of glaucoma. The highest glaucoma discriminative ability was observed for the combination of pRNFL sectors or inner macular segments (AUC: 0.83 and 0.85, respectively), although sensitivity remained moderate (both 63% at 95% specificity). In conclusion, while confirmation from investigations in larger cohorts is required, SD-OCT-derived pRNFL and macular thickness measurements seem highly valuable for the diagnosis of paediatric glaucoma.

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Section: Discussionsupporting

confidence: 94%

The Paediatric Glaucoma Diagnostic Ability of Optical Coherence Tomography: A Comparison of Macular Segmentation and Peripapillary Retinal Nerve Fibre Layer Thickness

Lever

Halfwassen

Unterlauft

et al. 2021

Biology

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“…Additionally, our analysis may be useful for analyzing cpRNFL data from children excluded from clinical studies because of their eye movement artifacts. 6,7 Further studies will be required to address the application of the methodology and determine the sensitivity/specificity to detect cpRNFL loss when the reference scan is misaligned from the optic disc center.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore subjects with large eye movements or nystagmus are excluded from clinical studies because of artifacts. 6,7 Sophisticated methods have proposed motion artifact correction using multiple orthogonal OCT volumes. [8][9][10][11] Unfortunately, these methods incorporate custom volumetric OCT scanning methods or use hardware that is unavailable on commercial devices.…”

Section: Introductionmentioning

confidence: 99%

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Matching Misaligned Spectralis OCTs to a Reference Scan in Pediatric Glaucoma with Poor Fixation and Nystagmus

Kelly

Baran

Phillips

et al. 2020

Trans. Vis. Sci. Tech.

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Poor fixation or nystagmus in children causes misalignment errors when measuring circumpapillary retinal nerve fiber layer (cpRNFL) thickness by simultaneous scanning laser ophthalmoscope imaging/optical coherence tomography (SLO/OCT). We investigated a method to assess cpRNFL from misaligned SLO/OCT scans. Methods: Heidelberg Spectralis SLO/OCT scans from a single clinical examination were retrospectively analyzed when automated eye tracking was unreliable. Retinal layer thickness was measured at overlapping match locations between a reference and misaligned scans based on the position data from simultaneously acquired SLO images. Three layers were segmented: cpRNFL, internal limiting membrane to outer nuclear layer (ILM-ONL), and total retinal thickness (TR). Accuracy was defined as the difference in thickness between the reference and misaligned scans at their match locations after correction for scan angle. Results: Thirty-five subjects, evaluated for glaucomatous nerve loss, met inclusion criteria. Group-averaged accuracy was −2.7, 1.4, and 0.3 μm for cpRNFL, ILM-ONL, and TR thickness, respectively. Across all layers, interobserver intraclass correlation coefficients ranged from 0.97 to 0.63 and the maximum Bland-Altman 95% limits of agreement were −21.6 to 20.7 μm. Variability was greatest for cpRNFL thickness and least for TR thickness. Increased variability was associated with lower signal-to-noise ratio but not with image-motion indices of shear, rotation, and scale. Conclusions: Retinal layer thickness can be compared to a reference cpRNFL OCT scan when poor fixation and nystagmus causes misalignment errors. The analysis can be performed post hoc using multiple misaligned scans from standard SLO/OCT protocols. Translational Relevance: Our method allows for assessment of cpRNFL in children who fail eye tracking.

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“…Some researchers have reported the thinning of average pRNFL thickness in all sectors between pediatric glaucoma and controls (25)(26)(27)(28)(29)(30). However, other studies have found that children with glaucoma and normal participants have comparable pRNFL thickness in some regions such as the temporal, nasal, and inferior nasal quadrants (31)(32)(33)(34). Thus, the possible association of each sector between pRNFL thickness and childhood glaucoma remains unclear, which justifies the need for more studies on this issue.…”

Section: Introductionmentioning

confidence: 99%

Changes of Peripapillary Retinal Nerve Fiber Layer in Childhood Glaucoma: A Systematic Review and Meta-Analysis

2021

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Objectives: Retinal nerve fiber layer (RNFL) thickness has been detected by numerous studies about alterations and abnormalities in childhood glaucoma, but these studies have yielded inconsistent results about the RNFL thinning region. The investigation of characteristics of RNFL in pediatric patients would contribute to the deep understanding of the neuropathic mechanisms of childhood glaucoma. Thus, the degree of thinning in different quadrants deserves further discussion and exploration.Method: A systematic literature search was conducted using the Cochrane Central Register of Controlled Trials, Medline, Embase, and PubMed databases to identify clinical studies published from inception to April 1, 2021.Results: Ten studies were included in this review with a total of 311 children with glaucoma and 444 in nonglaucomatous controls. The results revealed that average peripapillary RNFL (pRNFL) thickness was attenuated in pediatric patients with glaucoma [weighted mean difference (WMD) = −20.75; 95% CI −27.49 to −14.01; p < 0.00001]. Additionally, pRNFL thickness in eight quadrants (superior, inferior, temporal, nasal, superotemporal, inferotemporal, superonasal, and inferonasal) had different levels of reduction in the pediatric group of glaucoma.Conclusion: This study indicates that eight regions of RNFL thickness show various degrees of thinning in childhood glaucoma. However, caution is required in the interpretation of results due to marked heterogeneity. Future studies, especially larger samples and multicenter, need to confirm our results.

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Retinal nerve fiber layer thickness in children with primary congenital glaucoma measured by spectral domain optical coherence tomography

Cited by 8 publications

References 23 publications

The Paediatric Glaucoma Diagnostic Ability of Optical Coherence Tomography: A Comparison of Macular Segmentation and Peripapillary Retinal Nerve Fibre Layer Thickness

The Paediatric Glaucoma Diagnostic Ability of Optical Coherence Tomography: A Comparison of Macular Segmentation and Peripapillary Retinal Nerve Fibre Layer Thickness

Matching Misaligned Spectralis OCTs to a Reference Scan in Pediatric Glaucoma with Poor Fixation and Nystagmus

Changes of Peripapillary Retinal Nerve Fiber Layer in Childhood Glaucoma: A Systematic Review and Meta-Analysis

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