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Clinical science
Correlation between optical coherence tomography and glaucomatous optic nerve head damage in children
  1. M A El-Dairi,
  2. S Holgado,
  3. S G Asrani,
  4. L B Enyedi,
  5. S F Freedman
  1. Duke University Eye Center, Durham, North Carolina, USA
  1. Correspondence to Dr, S F Freedman, Duke University Eye Center, 2308 Erwin Rd, Durham, NC 27710, PO Box: 3802, USA; freed003{at}


Aim: To compare analysis of macular and nerve fibre layer thickness by optical coherence tomography (OCT) with optic nerve head (ONH) morphology based on 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, California, USA). Fast macular and retinal nerve fibre 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: OCT measurements of RNFL and macular thickness declined 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 paediatric glaucoma.

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  • Funding Research to Prevent Blindness unrestricted departmental grant.

  • Competing interests None declared.

  • Ethics approval The study was compliant with the Health Insurance Portability and Accountability Act (HIPAA). The study was approved by the Duke University Medical Center’s Institutional Review Board.

  • Patient consent Obtained.