Distribution of Optic Disc Parameters Measured by OCT: Findings from a Population-Based Study of 6-Year-Old Australian Children

Abstract

To study the distribution of optic disc, cup, and neural rim size by ocular and demographic variables in a population-based sample of 6-year-old children. The Sydney Childhood Eye Study examined 1765 of 2238 eligible 6-year-old children (78.9%) from 34 randomly selected Sydney schools during 2003 to 2004. Comprehensive standardized eye examination included cycloplegic autorefraction, optical biometry and "fast optic disc" scans performed using optical coherence tomography. Scans of adequate quality were available for 1309 children (75% of participants), with 70% aged 6 years; 50.9% were boys. Mean (+/- SD) horizontal and vertical disc diameter and disc area was 1.53 +/- 0.21 mm, 1.79 +/- 0.28 mm, and 2.20 +/- 0.39 mm(2), respectively. Corresponding cup dimensions were 0.70 +/- 0.28 mm, 0.73 +/- 0.27 mm, and 0.48 +/- 0.32 mm(2). A definable optic cup was absent in 7.4%, 87% of whom were European white. Cup-to-disc diameter ratios were 0.46 +/- 0.16 horizontally and 0.42 +/- 0.15 vertically, whereas cup-to-disc area ratio was 0.22 +/- 0.13. Mean +/- SD neural rim area was 1.76 +/- 0.44 mm(2) and increased with disc size (Pearson correlation = 0.68, P < 0.0001). Horizontal and vertical average nerve widths were 0.36 +/- 0.05 and 0.28 +/- 0.05 mm, respectively. In analyses adjusting for potential confounders, disc area increased significantly with axial length (P(trend) < 0.0001) and refraction (P(trend) = 0.02). Rim area increased only with axial length (P(trend) = 0.01). There were no gender differences, except for average nerve width, marginally greater in boys. Most disc and cup dimensions were significantly larger in East-Asian than European white and Middle Eastern children. Disc, cup, and neural rim parameters were generally normally distributed in this young population. Axial length appeared to be a stronger determinant of disc and rim size than refraction. Some ethnic but not gender differences were demonstrated for most parameters.