Reliability and Recommended Settings for Pediatric Circumpapillary Retinal Nerve Fiber Layer Imaging Using Hand-Held Optical Coherence Tomography (original) (raw)
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American journal of ophthalmology, 2014
To determine the intra- and intervisit reproducibility of circumpapillary retinal nerve fiber layer (RNFL) measures using handheld optical coherence tomography (OCT) in sedated children. Prospective cross-sectional and longitudinal study. Children undergoing sedation for a clinically indicated magnetic resonance imaging for an optic pathway glioma and/or neurofibromatosis type 1 (NF1) had multiple 6 × 6 mm volumes (isotropic 300 × 300 or nonisotropic 1000 × 100 samplings) acquired over the optic nerve. Children with 2 handheld OCT sessions within 6 months were included in the intervisit cohort. The intra- and intervisit coefficient of variation (CV) and intraclass correlation coefficient (ICC) were calculated for the average and anatomic quadrant circumpapillary RNFL thickness. Fifty-nine subjects (mean age 5.1 years, range 0.8-13.0 years) comprised the intravisit cohort and 29 subjects (mean age 5.7 years, range 1.8-12.7 years) contributed to the intervisit cohort. Forty-nine subje...
American Journal of Ophthalmology, 2012
PURPOSE: To determine the normative values of the peripapillary retinal nerve fiber layer (RNFL), macular thickness, and macular volume in healthy children using spectral-domain optical coherence tomography (SD-OCT) and analyze the correlation of such values with age, refraction error, and biometric measurements. • DESIGN: Observational case series. • METHODS: This institutional study involved 107 eyes from 107 healthy pediatric patients (54 female, 53 male) with ages between 6 and 16 years. After the biometric measurements and refractive error values (in spherical equivalent) of the cases were obtained, the peripapillary RNFL, macular thickness, and macular volume values were calculated using the Spectralis OCT device. • RESULTS: Among the study group, with an average age of 10.46 ؎ 2.94 years, the average axial length (AL) was 23.33 ؎ 0.89 mm; the average spherical equivalent (SE) value was ؊0.27 ؎ 0.99 diopter. The average peripapillary RNFL thickness was 106.45 ؎ 9.41 m; the average macular thickness was 326.44 ؎ 14.17 m; and the average macular volume was 0.257 ؎ 0.011 mm 3 . The aforementioned OCT measurements were not significantly correlated with age, SE, or AL values (P > .05 for all). • CONCLUSIONS: This study reports SD-OCT findings among healthy pediatric cases. SD-OCT can be reliably used for pediatric patients because of its short exposure time and high degree of image resolution. (Am J Ophthalmol 2012;153:552-559.
Systematic reviews, 2016
The parameters of the optic disc and peripapillary retinal nerve fibre layer (pRNFL) in children may vary with disease processes that contribute to visual impairment and blindness and so could be useful as an objective measure in at-risk children. There is no standardised reference for the normal parameters of the optic disc and pRNFL in children; however, there are a large number of small individual studies that have been undertaken to look at these measures. A systematic review of current literature on the range of pRNFL and optic disc parameters in children aged less than 18 years will be performed. Studies will be considered for review if they report numerical data on optic disc and pRNFL parameters, measured using optical coherence tomography. Outcome measures will include mean pRNFL thickness and cup-disc ratio. The bibliographic databases Medline, CINAHL, EMBASE, Scopus and Web of Science will be systematically searched from 1991. Screening of search results will be conducted...
Journal of ophthalmic and vision research, 2018
Purpose: This study aimed to measure the peripapillary retinal nerve fiber layer (RNFL) thickness using spectral-domain optical coherence tomography (SD-OCT) in normal Iranian children aged below 18 years. Methods: Peripapillary RNFL imaging was performed in the right eye of normal Iranian children aged below 18 years using Spectralis SD-OCT (Heidelberg Engineering; Vista, CA). The effects of age, gender, cup-to-disc ratio, and spherical equivalent (SE) on global and sectoral RNFL thicknesses were evaluated. Results: A total of 115 eyes were imaged. Approximately 51 (44.3%) of the cases were female children. The mean age was 12.44 ± 2.52 years. The SE of refractive error was 0.39 ± 1.38 diopters (range: −3.00 to +4.5 D). The RNFL thickness measurements in the superior, inferior, nasal, and temporal quadrants were 129.
Indian Journal of Ophthalmology, 2017
To determine interocular differences in the retinal nerve fiber layer (RNFL) and optic nerve head (ONH) parameters in a pediatric population using Cirrus high-definition optical coherence tomography (HD-OCT). Methods: Seventy normal Indian children aged 5-17 years presenting to the Pediatric Clinic were included in this observational cross-sectional study. All subjects underwent a comprehensive ophthalmologic examination and an evaluation of the RNFL and ONH by Cirrus HD-OCT. Differences between the right and left eyes were calculated and values were compared by means of a paired t-test. Subjects were also divided into two groups based on age (under or over 10 years of age). Interocular differences in RNFL and ONH parameters together with sex and age variations for these differences were determined. Results: The mean age of studied pediatric population was 11.83 ± 3.3 years (range 5-17). Average RNFL thickness was 94.46 ± 8.7 µm (± SD) (range 77-111). Differences in the average RNFL between right and left eyes were not statistically significant (P = 0.060). Superior quadrant RNFL was thicker in the left eye and temporal quadrant was thicker in the right eye. Among ONH parameters, there were no statistically significant differences in any parameters, except vertical cup-disc (CD) ratio which was significant (P = 0.007). The 2.5%-97.5% limits of asymmetry were 9 µm for average RNFL, 0.14 for average CD ratio, and 0.22 for vertical CD ratio. Mean interocular RNFL thickness differences in superior, superior nasal, and temporal superior quadrants were 10.61 (P < 0.001), 12.57 (P < 0.001), and 4.46 (P = 0.002) µm, respectively. Interocular nerve fiber layer thickness differences were not significantly correlated with sex, while only significant differences with age were observed in 12 clock hour sector analysis, mainly in nasal inferior and inferior quadrant. Conclusions: We report the degree of interocular symmetry of RNFL and ONH parameters measured by Cirrus HD-OCT in a healthy pediatric population. The normal interocular RNFL asymmetry should not exceed 9 µm and vertical CD ratio beyond 0.22 should be considered for further investigations. The physiologic asymmetry provided by this study may assist in identifying changes in RNFL thickness and ONH parameters in pediatric glaucoma and ONH disorders.
Graefe's Archive for Clinical and Experimental Ophthalmology, 2015
Background To determine the applicability of the ISNT (i n f e r i o r > s u p e r i o r > n a s a l > t e m p o r a l) a n d I S T (inferior>superior>temporal) rules on retinal nerve fiber layer (RNFL) measurement on spectral-domain optical coherence tomography (SD-OCT) in normal children. Methods A prospective, cross-sectional study including consecutive subjects between the ages of 5-18 years who were born at term (≥37 weeks gestational age) and with a normal birth weight (≥2500 g) presenting to the outpatient department for refractive error examination. RNFL measurement was done on Spectralis SD-OCT. Exclusion criteria were best-corrected visual acuity less than 20/20, spherical equivalent (SE)>± 5 diopter (D), applanation IOP >21 mmHg, cupto-disc (C/D) ratio of >0.5, C/D ratio asymmetry of >0.2 between eyes and any retinal or optic disc anomaly as determined by mydriatic fundus examination. Subjects with amblyopia, strabismus, or family history of optic nerve or retinal disease were excluded. Poor cooperation for SDOCT imaging and lack of consent were other exclusion criteria. Results The ISNT rule on the RNFL was followed only by 30 eyes (23.8 %), while the IST rule was followed by 66 eyes (52.4 %) (p<0.001). The superior RNFL was thicker than the inferior in 57 eyes (45.2 %) while the temporal RNFL was thicker than the nasal in 63 eyes (50 %). The age, gender, spherical equivalent, and disc size did not predict the followability of the ISNT and IST rules (p>0.05). Conclusions The ISNT and the IST rules for RNFL are not universally followed by all normal eyes in children. All deviations should therefore not be considered pathological.
ISRN Ophthalmology, 2012
Objective. The aim of this study was to test the reproducibility of the Heidelberg Spectralis SD-OCT and to determine if provided software retest function for follow-up exam is superior to manual centration. Design. Prospective, cross-sectional study. Participants. 20 healthy subjects. Methods. All subjects underwent SD-OCT testing to determine retinal nerve fiber layer (RNFL) measurements sequentially on two different days and with two different centration techniques. Within-subject standard deviation, coefficient of variation, and intraclass correlation coefficient were used to assess reproducibility. Results. RNFL measurements showed high reproducibility, low within-subject standard deviation (1.3), low coefficient of variation (0.63%), and low intra-class correlation coefficient (0.98 (95% CI 0.97-0.99)) in the automated centration and manual centration groups for average RNFL Thickness. Quadrants showed slightly higher variability in the manual group compared to the automated group (within-subject standard deviation 2.5-5.3 versus 1.1-2.4, resp.). Conclusions. SD-OCT provides high-resolution RNFL measurements with high reproducibility and low variability. The re-test function allows for easier recentration for longitudinal examinations with similar results in average RNFL, but less variability in quadrant RNFL. SD-OCT high reproducibility and low variability is a promising fact and should be further evaluated in longitudinal studies of RNFL.
Journal of ophthalmic & vision research, 2014
To determine the agreement between Spectralis and Cirrus spectral domain optical coherence tomography (SD-OCT) measurements of peripapillary retinal nerve fiber layer (RNFL) thickness. Suspected or confirmed cases of glaucoma who met the inclusion criteria underwent peripapillary RNFL thickness measurement using both the Spectralis and Cirrus on the same day within a few minutes. Measurements were performed on 103 eyes of 103 patients with mean age of 50.4±17.7 years. Mean RNFL thickness was 89.22±15.87 versus 84.54±13.68 µm using Spectralis and Cirrus, respectively. The difference between measurements and the average of paired measurements with the two devices showed a significant linear relationship. Bland-Altman plots demonstrated that Spectralis thickness values were systematically larger than that of Cirrus. Spectralis OCT generates higher peripapillary RNFL thickness readings as compared to Cirrus OCT; this should be kept in mind when values obtained with different instruments...