A Cohort Study to Evaluate the Evolution of the Optic Nerve Head Parameters and Inner Retinal Thickness During Childhood

Abstract

Purpose: To compare children's stereometric optic disc parameters and inner retinal thickness measured by optical coherence tomography (OCT) in two different moments in life in the same children and to establish a correlation between the optic nerve head (ONH) area and the difference of these parameters in the two observations. Methods: In this observational cohort, children were evaluated on two occasions: at 6.7 ± 1.6 and 13.2 ± 0.7 years of age. Cup volume, neuroretinal rim (NRR) area, average cup-to-disc ratio, peripapillary retinal nerve fiber layer (pRNFL), and ganglion cell inner plexiform layer (GCIPL) were measured by the Cirrus HD-OCT (Carl Zeiss Meditec AG). Results: A total of 175 children were included, 89 boys (50.9%) and 86 girls (49.1%). There was a significant decrease of the NRR area ( P < .001) and increase of the cup volume ( P < .001) on the second observation. The pRNFL thickness and GCIPL thickness also decreased ( P < .001 and P = .002, respectively). There was a positive correlation between the ONH area and the difference of the cup volume ( P = .047; r = 0.102) and a negative correlation with the difference of the NRR area ( P < .001; r = 0.237). Conclusions: During childhood, there is an increase of the cup volume, a decrease of the NRR area, and a decrease of inner retinal layer thickness (more significant in the superior and inferior quadrants) measured by OCT. This study demonstrates that in children with large discs the enlargement of the cup and decrease of the NRR is more evident. Considering these changes, the physiological enlargement of the cup in a child with a large disc can be misinterpreted as the development of a glaucomatous lesion. [ J Pediatr Ophthalmol Strabismus . 20XX;X(X):XXX–XXX.]