Purpose: To compare analysis of macular and nerve fiber layer thickness by optical coherence tomography (OCT), to optic nerve head (ONH) morphology based upon stereophotography.
Design: Prospective observational case control series.
Methods: Normal and glaucomatous eyes of children (age 4-17 years) were scanned using Stratus OCT (Carl Zeiss Meditec, Dublin, CA). Fast macular and retinal nerve fiber layer (RNFL) thickness map were performed on 372 eyes of 222 children. ONH stereophotographs were taken and evaluated by two masked observers, using a grading system of 0 to 5 based on both cupping ratio and morphology. OCT3 analyses were compared across ONH grades for different areas around the macula and the peripapillary RNFL.
Results: Analysis included OCT values and ONH grading for 139 eyes of 139 children. There was a negative correlation between ONH grade and both macular thickness and RNFL thickness in all areas measured. There was a difference in the correlation identified for black versus white children.
Conclusion: We report that OCT measurements of RNFL and macular thickness decline with increasing grade of glaucomatous damage seen on stereophotographs in black and white children. Further study will help quantify the value of OCT in the diagnosis and management of pediatric glaucoma.