Abstract
The purpose of this study was to identify the normative values of ganglion cell-inner plexiform layer (GCIPL) thickness in healthy Korean children using swept-source optical coherence tomography (SS-OCT) and to investigate the correlations of age, refractive error, axial length (AL), retinal nerve fiber layer (RNFL) thickness and cup-to-disc (C/D) ratio with GCIPL thickness. Children aged between 3 and 17 who had visited our pediatric ophthalmology clinic were enrolled. Each subject underwent full ophthalmic examinations including RNFL thickness, C/D ratio and GCIPL thickness measurement by SS-OCT as well as AL measurement by partial-coherence interferometry. A total of 254 eyes of 127 children were included. The mean average GCIPL thickness was 71.5 ± 5.35 μm; the thickest sector was the superonasal and the thinnest the inferior. According to multivariate regression analysis, average GCIPL thickness was significantly associated with spherical equivalent and RNFL thickness (P < 0.0001 for both): the higher the myopia or the thinner the RNFL thickness, the thinner the GCIPL thickness. In conclusion, this study provides an SS-OCT-based pediatric normative database of GCIPL thickness that can serve as a reference for early detection and follow-up of glaucoma and optic nerve diseases in children.
Highlights
Optical coherence tomography (OCT) is a noninvasive, noncontact and objective high-resolution cross-sectional tissue imaging technique[1] that has been widely used in recent years in the diagnosis and follow-up of glaucoma, macular diseases and optic nerve diseases
Our present results in children with Swept-source OCT (SS-OCT), the latest commercially available version of OCT, showed intra-class correlation coefficient (ICC) value of intra-observer repeatability of 0.972 for the average ganglion cell-inner plexiform layer (GCIPL) thickness. It was comparable with the results obtained with previous version of OCT in children and with those obtained in adults[24,25,26,27,28]
Average GCIPL thickness was 71.6 ± 5.35 μm, superonasal GCIPL 75.1 ± 5.72 μm, and inferior GCIPL 66.8 ± 5.95 μm. These values were significantly thinner than in those previous studies noted above, which discrepancy was due to the different OCT versions employed: SS-OCT versus Spectral-domain OCT (SD-OCT)
Summary
Optical coherence tomography (OCT) is a noninvasive, noncontact and objective high-resolution cross-sectional tissue imaging technique[1] that has been widely used in recent years in the diagnosis and follow-up of glaucoma, macular diseases and optic nerve diseases. Measurement of macular GCIPL thickness has been shown to be useful for estimation of early axonal loss in optic neuropathies such as optic neuritis or nonarteritic anterior ischemic optic neuropathy[13,14]. Such measurement can be helpful for detection of early retinal toxicity due to hydroxychloroquine or early optic nerve change due to ethambutol[15,16]. We undertook the present study to identify, by SS-OCT, normative data on the macular GCIPL in healthy Korean children and to investigate their correlations with biometric factors such as age, refractive error (spherical equivalent, SE), axial length (AL), RNFL thickness and cup-to-disc (C/D) ratio
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