https://orcid.org/0000-0001-5697-411X
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ABSTRACT
Clinical relevance
The detection of abnormal values of peripapillary nerve fibre layer (pRNFL) thickness measured with optical coherence tomography (OCT) is important for detecting optic nerve disease in children.
Background
To evaluate the level of agreement between the adult reference database supplied with an OCT device and the present paediatric study database for the measurement of pRNFL thickness in children. This study also aimed to provide reference values for pRNFL thickness according to the spherical equivalent in the paediatric population.
Methods
This was a cross-sectional study. One hundred and twenty-six healthy children were included, who had undergone a full ophthalmological examination including cycloplegic refraction and examination of pRNFL thickness using the Topcon 3D OCT 2000 device (Topcon Corporation, Tokyo, Japan). Values equal to or below the fifth percentile (≤p5) and above the 95th percentile (>p95) were considered abnormal. Observed agreement and specific agreement were investigated between OCT measurements classified with paediatric and adult reference values for normality.
Results
Values ≤ p5 in the adult database were recorded for 2 of the 30 values (6.6%) of the pRNFL values by quadrants ≤p5 in the paediatric database and 17 of the 88 (19.3%) values by sectors ≤p5. For values >p95 in the adult database, 88% by quadrants and 72% by sectors would have been classified as being within the normal range using the paediatric database.
Conclusion
The use of adult reference values currently available in OCT devices can lead to classification errors concerning the normal range of pRNFL thickness in a large proportion of paediatric patients. The use of normative paediatric databases, such as the one discussed in this study, should be taken into consideration.
Acknowledgements
The authors wish to acknowledge Beatriz De-Lucas-Viejo and Javier Sambricio for their contribution to ophthalmological examinations and Tomas O’Boyle for writing assistance. The authors have no conflict of interest to declare. The preparation of the article was funded by the National Institute of Health Carlos III (Grant PI 17/01073).
Disclosure statement
No potential conflict of interest was reported by the author(s).
Author’s contributions
PTP is the project leader. PTP and AMG developed the original concept. AMG designed the present study with support from PTP. AMG, MRS, and JLTP participated in patient recruitment and data collection. AMG, JDC, and JLTP designed all statistical plans. JLTP performed the data analysis. AMG and JLTP interpreted the results. AMG wrote the manuscript with support from PTP and JDC. All authors (AMG, PTP, JDC, MRS, JLTP, CLL, and AOO) discussed the results and contributed to the final manuscript. They also read and approved the final manuscript.
Consent to participate
Parents or guardians of all enrolled participants, and children aged ≥12 years provided their written informed consent.
Ethics approval
The protocol of this cross-sectional study was approved by the Ethics Committee and Research Board at each recruitment centre. The study protocol adhered to the guidelines of the Declaration of Helsinki for research involving human participants.