Abstract

BackgroundVariations in optic nerve head morphology and abnormal retinal vascular pattern have been described in preterm children using digital image analysis of fundus photograph, optical coherence tomograph and serial funduscopy. We aimed to compare the optic nerve head parameters in preterm and term Malay children using Heidelberg Retinal Tomograph III.DesignA cross sectional study.Methodology/Principal FindingsThirty-two preterm Malay children who were born at up to 32 weeks postconception, and 32 term Malay children aged 8–16 years old were recruited into this cross sectional study, which was conducted in the Hospital Universiti Sains Malaysia, Malaysia from January to December 2011. Their optic nerves were scanned and analyzed using a Heidelberg Retinal Tomography (HRT) III (Heidelberg Engineering, Germany). Preterm children showed an increased rim volume (SD) (0.56 (0.26) vs 0.44 (0.18) mm3, respectively), smaller cup shape (SD) (0.18 (0.07) vs 0.25 (0.06) mm, respectively), increased height variation contour (SD) (0.44 (0.14) vs 0.35 (0.08) mm, respectively), and increased cup depth (SD) (0.24 (0.11) vs 0.17 (0.05) mm3, respectively) when compared to their normal peers (p<0.05). There were no significant differences in the mean disc area, cup area, cup to disc ratio or rim area between the preterm and term children (p>0.05) in our study.Conclusions/SignificancePreterm children exhibit different characteristics of optic nerve head parameters with HRT III analysis. Increased cup depth in preterm children suggests a need for close observation and monitoring. It may raise suspicion of pediatric glaucoma when proper documentation of intraocular pressure and clinical funduscopy are unsuccessful in uncooperative children.

Highlights

  • The use of newer technologies such as digital analysis of fundus photographs, retinal and optic nerve head imaging, and RetCam image analysis have improved the diagnostic accuracy and management of pediatric eye diseases [1,2,3,4,5,6,7,8,9,10,11,12]

  • Variations in optic nerve head morphology and abnormal retinal vascular pattern have been described in preterm children using the above modalities [4,5,7,8,9,10,11,12]

  • We further analyzed the optic nerve head parameters of the preterm and term children according to the age and gender, and we found no statistically significant differences (p.0.05)

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Summary

Introduction

The use of newer technologies such as digital analysis of fundus photographs, retinal and optic nerve head imaging, and RetCam image analysis have improved the diagnostic accuracy and management of pediatric eye diseases [1,2,3,4,5,6,7,8,9,10,11,12]. Variations in optic nerve head morphology and abnormal retinal vascular pattern have been described in preterm children using the above modalities [4,5,7,8,9,10,11,12]. The above studies were confined mainly to preterm infants and/or children using digital image analysis of fundus photograph, optical coherence tomography (OCT) and serial funduscopy [4,5,7,8,9,10,11,12,13]. Variations in optic nerve head morphology and abnormal retinal vascular pattern have been described in preterm children using digital image analysis of fundus photograph, optical coherence tomograph and serial funduscopy.

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