Untersuchung der Papillenmorphologie bei frühgeborenen Kindern mit Hilfe des Heidelberger Retina Tomographen (HRT II) und der optischen Kohärenztompgraphie (RTVue 100)
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Philipps-Universität Marburg
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Abstract
Summary:
Aim of the study:
The aim of the following study with the title: „Investigation of optic nerve parameters in preterm children measured with Heidelberg retina tomograph (HRT II) and optical coherence tomography (RTVue 100)“, was to illustrate the differences in optic nerve parameters and retinal nerve fibre layer between preterm children and full term children. To the best of our knowledge no other study examined the optic nerve head morphology by OCT in prematurely born children at school age and compared them with term born children of the same age. The results of measurements with the HRT and the OCT between the both groups and their correlation with age, axial length and spherical equivalent (SE) were examined. In the preterm group (PG) the correlation between peripapillary nerve fibre layer thickness with birth weight and gestational age was determined.
Material and methods:
The group of participants comprised 52 preterm children (PG) and 51 full term children (TG). The age ranged from 5 to 16 years. The eyes of the children were examined with IOL-Master (axial length), HRT II and OCT (RTVue 100). Cycloplegic refraction was measured and the spherical equivalent (SE) was calculated. Parameters of the optic nerve head and retinal nerve fibre layer thickness were measured and compared between both groups. Furthermore, their correlation with age, axial length and spherical equivalent and correlation of the optic nerve head parameters and RNFL of preterm children with birth weight and gestational age were calculated.
Results:
Comparison between preterm group and full term group
Regarding age, axial length and visual acuity no significant differences between the both groups were found. SE in the PG was significantly lower (PG: +0,58 dpt; TG: +1,66 dpt).
OCT: The RNFL-thickness in the preterm group in nasal (PG: 72,39 ± 12,31 μm, TG: 82,26 ± 18,45 μm) and inferior area (FG: 130,3 ± 21,67 μm, NG: 141,9 ± 20,95 μm) was significantly smaller than in full term children. Overall RNFL (PG: 101,6 ± 13,2 μm, TG: 110,8 ± 13,77 μm) was significantly smaller in the PG too.
Optic nerve head parameters measured with the OCT und the HRT did not show any significant differences between the both groups.
Correlation of age with optic nerve head parameters and RNFL
There were no significant correlations between RNFL and age as well as between optic nerve head parameters and age by OCT and HRT measurements.
Correlation of axial length and SE with optic nerve head parameters and RNFL
OCT: Axial length correlated statistically significant with the rim area in the TG (r = -0,4797; Pʙ = 0,0042). Between SE and RNFL or optic nerve head parameters measured with OCT no significant correlations were found.
HRT: In both groups there were no significant correlations between axial length and optic nerve head parameters. SE correlated significantly negative with disc area (r =-0,4079; Pʙ = 0,027) and cup area (r =-0,4117; Pʙ = 0,024) in the preterm group.
Correlation of birth weight and gestational age with optic nerve head parameters and RNFL in PG
OCT: Statistically, gestational age correlated significantly negative with cup area (r = -0,43; Pʙ = 0,015), cup volume (r = -0,403; ʙ = 0,031), C/D ratio (r = -0,414; Pʙ = 0,023) and C/D horizontal ratio (r = -0,408; Pʙ = 0,027). After adjusting of the p-values there were no significant correlations between optic nerve head parameters or RNFL regarding birth weight.
HRT: Statistically, birth weight correlated significantly negative with cup area (r = -0,4175; Pʙ = 0,021), C/D ratio (r = -0,3929; Pʙ = 0,039) and linear C/D ratio (r = -0,4077; Pʙ = 0,03). Statistically, gestational age correlated significantly negative with disc area (r = -0,4413; Pʙ = 0,011), cup area (r = -0,517; Pʙ = 9,243 x10^-3), cup volume (r = -0,4159; Pʙ = 0,022), C/D ratio (r = -0,4522; Pʙ = 7,7742x10^-3) and linear C/D ratio (r = -0,4024; Pʙ = 0,034).
There was a significant positive correlation between gestational age and SE (r= 0,297; P = 0,0327) and birth weight and SE (r = 0,278; P = 0,0461) in PG.
Discussion:
Both instruments can be used for children's clinical examinations. Differences between preterm and full term children could be determined by the OCT, but not by the HRT. In the present study and in many other studies RNFL was significantly thinner in preterm children.
Our investigation showed birth weight and gestational age to have a large impact on the optic nerve head parameters in preterm children when measured by OCT and HRT. Cup volume and cup area become larger with decreasing gestational age and birth weight. Therefore we conclude that very preterm children with a very low birth weight mostly have larger optic nerve cup than full term children. As a result this would consequently mean that a large optic nerve cup in very preterm children with normal ocular pressure is a structural optic nerve condition rather than a sign of glaucoma. Thus, unnecessary treatment might be avoided in the future.
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Dates
Created: 2019Issued: 2019-08-19Updated: 2019-08-19
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
preterm childrenoptic nerve head parametersOCTRNFLHRT
DFG-subjects
HRTfrühgeborene KinderRNFLSehnervenkopfparameterOCT
DDC-Numbers
610
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Kunze, Kira: Untersuchung der Papillenmorphologie bei frühgeborenen Kindern mit Hilfe des Heidelberger Retina Tomographen (HRT II) und der optischen Kohärenztompgraphie (RTVue 100). : Philipps-Universität Marburg 2019-08-19. DOI: https://doi.org/10.17192/z2019.0028.
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This item has been published with the following license: In Copyright