Spectralis Spectral Domain Ocular Coherence Tomography in the Supine Child: Normative Reference Ranges for Children Ages 0-5 Years
Jill Rotruck, MD; Robert House, MD; Laura Enyedi, MD; Sharon Freedman, MD; Mays El-Dairi, MD
Introduction: Spectral domain optical coherence tomography (SD-OCT) is useful in identifying/managing macular and optic nerve pathology; however, normative reference ranges are lacking for very young children.
Purpose: to develop norms for macular layers and peri-papillary retinal nerve fiber layer (pRNFL) thicknesses in young children’s healthy eyes using Spectralis (Heidelberg, Germany) SD-OCT.
Methods: Ongoing, prospective, IRB-approved study of healthy, full-term (>/=37 weeks) children ages 0-5 years undergoing general anesthesia for eye examination/procedure with at least one normal eye (excluded any ocular or neurologic disease and refractive error outside -3Diopters to +8Diopters). Ocular data collected included: intraocular pressure, axial length and refraction. The optic nerve and macula in one eye/child were imaged with a portable Heidelberg Spectralis unit mounted on a Flex arm. Analyses were performed with Heidelberg SD-OCT segmentation software.
Results: Thirty-four eyes (34 children) are included to date; 19 females; mean age 2.4±1.5 years. Mean spherical equivalent was +1.5±1.3D, with mean axial length 21.05±1.12mm. Mean macular central subfield thickness was 239.3±29.5µm and mean total average macular volume was 8.52±0.40mm3. Mean pRNFL thickness was 108.6±11.2µm. Macular central subfield thickness and outer nuclear layer volume increase with greater age and axial length. No significant relationships were found between pRNFL and age or axial length.
Discussion: Normative Spectralis pRNFL measurements in children aged 0-5 are not different from those of older children (1).
Conclusion: There are physiologic variations in the macular structural anatomy in early age. Understanding these variations is important to diagnose and follow pathologic retinal and optic nerve conditions in this age group.
References: 1. El-Dairi, M, Sanjay, A, Enyedi, L, Optical Coherence Tomography in the Eyes of Normal Children. Arch Ophthalmic. 2009;127(1):50-58