Retinal Nerve Fiber Layer and Macular Thickness Measurements in Children After Cataract Surgery Compared With Age-Matched Controls

Abstract

To compare the retinal nerve fiber layer (RNFL) and macular thickness in pediatric patients with congenital or developmental cataract after cataract surgery with age-matched controls using optical coherence tomography (OCT). Case-control study. setting: Institutional. Forty-five children (90 eyes) in the age group 4-16 years: subjects with unilateral congenital or developmental cataract (n= 15) and bilateral cataract (n= 15), and age-matched controls with no ocular abnormality (n= 15). Phacoaspiration and intraocular lens implantation was done in children with cataract. Retinal nerve fiber layer thickness (RNFLT) and central macular thickness (CMT) were measured using OCT in normal controls and 3months postoperatively in children with unilateral and bilateral cataract. Children with unilateral cataract had significantly thinner RNFL in affected eyes (85.46 ± 8.16μm) compared with the fellow eye (93.93 ± 13.12μm; P= .036). Average RNFLT in the operated eyes of unilateral cataract was significantly less (85.46 ± 8.16μm) compared to the control group (94.6 ± 12.51μm; P= .004). Average CMT in unilateral cataract (221 ± 42.05μm) was significantly less compared to normal control (245 ± 15.87μm; P= .004). Average RNFLT in bilateral cataract was similar in both eyes but significantly less compared to control group. Children with unilateral cataract showed significant thinning of superior, nasal, and temporal RNFL compared to the fellow eyes as well as age-matched normal eyes on OCT. The central macular thickness was less in deprivational amblyopic eyes than in age-matched normal eyes, but there was no significant difference compared to the fellow nonamblyopic eyes. In bilateral cataract, there was significant thinning of RNFL in superior and nasal quadrants as compared to age-matched normal eyes.