Abstract
Title: Morphological diagnostics in paediatric glaucoma Background: Morphological parameters vary in paediatric glaucoma with a minor knowledge on standard values available compared to an adult cohort. Accordingly, we designed a study to assess the objectively measured disc damage likelihood scale (DDLS) by KOWA stereophotography as a novel parameter in comparison to standard glaucoma diagnostics, HRT 3 and OCT. Methods and Findings: Prospective study of 47 eyes (n=47) categorized into three groups; 14 normal optic discs (11 female f, 3 male m, 12.7 ± 6.1years), 15 glaucoma suspects (3f, 12m, 11.7 ± 3.1years) and 18 paediatric glaucoma (10f, 8m, 11.2 ± 2.5years). Stereometric measurements of the optic disc by KOWA camera, Moorfields regression analysis (MRA) and glaucoma probability score (GPS) of the HRT3 and retinal nerve fibre layer (RNFL) of the OCT were analysed. Results were split in 2 groups: Diagnosis 1 was defined as “outside normal limits”, Diagnosis 2 as “borderline or outside normal limits”. Referring to Diagnosis 1 and 2, DDLS did not show a significant correlation with MRA, GPS and RNFL in glaucoma suspects, healthy children and paediatric glaucoma. In paediatric glaucoma the correlation of the GPS compared to KOWA rim/disc ratio was significant in all six quadrants; supernasal (r=-0.794 p=0.006), nasal (r=-0.845 p=0.002), inferonasal (r=-0.659 p=0.038), infertemporal (r=-0.636 p=0.048), temporal (r=-0.656 p=0.039) and superotemporal segment (r=-0.755 p=0.012). Regarding the area under the curve (Receiving operating characteristics ROC) the highest predictive power was demonstrated by DDLS (0.669-0.833) compared to R.Burk (0.142-0.595) and F.S.Mikelberg (0.050-0.619) coefficients considering all devices. Conclusions: The DDLS showed the highest predictive power for glaucomatous damage compared to glaucoma coefficients of the established devices. Additionally, the gold standard of optic nerve head assessment still includes the examination of the fundus photography. As stereo photography is an easy and timesaving instrument, it might be an additive tool in paediatric glaucoma.
Highlights
Various glaucoma parameters and new devices were developed for monitoring glaucoma patients and suspects recently [1,2,3,4,5,6]
The disc damage likelihood scale (DDLS) showed the highest predictive power for glaucomatous damage compared to glaucoma coefficients of the established devices
The gold standard of optic nerve head assessment still includes the examination of the fundus photography
Summary
Various glaucoma parameters and new devices were developed for monitoring glaucoma patients and suspects recently [1,2,3,4,5,6]. These techniques were usually adapted to an adult cohort [1,2,3,6]. Morphological optic nerve head (ONH) parameters such as the retinal nerve fibre layer (RNFL), Moorfields regression analysis (MRA), glaucoma probability score (GPS) and F.S. Mikelberg and R.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
