Item type:Thesis, Open Access

Untersuchung und Vergleich der Papillenmorphologie bei Kindern mit hoher Hyperopie mit dem Heidelberg Retina Tomographen (HRT II) und der optischen Kohärenztomographie (RTVue 100)

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Philipps-Universität Marburg

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Abstract

Purpose: The purpose of this study was the investigation and comparison of the optic disc morphology and the retinal nerve fibre layer thickness in children with high hyperopia compared with children with low hyperopia and emmetropia using Heidelberg retina tomography (HRT II) and optical coherence tomography (RTVue 100). The relationship between optic nerve parameters with age, spherical equivalent and axial length was determined. Methods: Children from 6-17 years were recruited from patients presenting to the ophthalmology department of the University clinic in Marburg. Patients with refractive error and strabismus were included in the study, but patients with any other diseases were excluded. A total of 68 subjects were included in the study. After a general eye examination, including cycloplegic refraction, all subjects underwent a special eye examination. Axial length of the eye was measured by means of the IOL-Master, optic disc morphology and retinal nerve fibre layer thickness in dilated pupils were measured by means of the Heidelberg retina tomography (HRT II) and the optical coherence tomography (RTVue 100). The subjects were divided into 2 groups based on their spherical equivalent. There were 37 subjects in group E (children with emmetropia and low hyperopia: SÄ ≥ -1 dpt and SÄ < 3 dpt) and there were 31 subjects in group H (children with high hyperopia: SÄ ≥ 3 dpt). The statistical evaluation was performed with „SPSS“ Version 22 (SPSS Inc., Chicago, Illinois, USA), „R Commander“ Version 1.8-1 and „R“ Version 2.14.1. Results: Our Study showed differences between children with high hyperopia and emmetropia with OCT and HRT II. There was a significant lower axial length in group H, than in group E. The older the children with emmetropia were, the larger their axial length was. In group H there was no significant difference between age and spherical equivalent or age and axial length. RNFL-thickness measured with OCT shows differences in the inferior and inferior-half area between both groups. There were no significant differences in the superior, temporal, nasal and the superior-half areal between both groups. Regarding to the RNFL measured with OCT our study did not show any correlation with age in both groups. There was also no significant difference between spherical equivalent and RNFL. But there was a significant and negative correlation between axial length and RNFL of all our subjects (group EH). The larger the axial length was, the less the RNFL thickness in inferior, superior-half und inferior-half areal was. Regarding to the parameters measured with HRT there were significant differences in disc area, cup area, cup volume, cup/disc area ratio, linear cup/disc ratio, mean cup depth and maximum cup depth between both groups (E and H). There were no significant differences in rim area, rim volume, cup shape measure, height variation contour, mean RNFL thickness, RNFL cross sectional area, reference height, topography SD, FSM discriminant function value and RB discriminant function value. Our study showed a significant positive correlation between age and cup shape measure and a significant negative correlation between age and topography SD and FSM in group E. In group H there was only a significant positive correlation between age and topography SD. There were significant negative correlations between spherical equivalent of all subjects (group EH) and a few HRT stereometric parameters. The larger the spherical equivalent, the smaller the cup area, cup volume, C/D Ratio, linear C/D Ratio, mean cup depth, maximum cup depth and RNFL cross sectional area was. In regards to the stereometric parameters of the optic nerve head measured with HRT our study showed positive correlations between axial length and all subjects (group EH). The larger the axial length, the larger the cup area, cup volume, C/D Ratio, linear C/D Ratio and mean cup depth was. Discussion: OCT in contrast to HRT II shows less differences between children with high hyperopia and emmetropia, which in turn demonstrates the importance of HRT measurement. Optic discs in highly hyperopic eyes are more crowded as they are smaller in diameter but possess similar rim volume as emmetropic eyes. Therefore optic disc in highly hyperopic eyes are more prominent, than in emmetropic eyes. In the future more patients with hyperopia and emmetropia should be measured by HRT and OCT to determine normal values for children and identify pathologies early.

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Brauer, Vanessa: Untersuchung und Vergleich der Papillenmorphologie bei Kindern mit hoher Hyperopie mit dem Heidelberg Retina Tomographen (HRT II) und der optischen Kohärenztomographie (RTVue 100). : Philipps-Universität Marburg 2017-09-07. DOI: https://doi.org/10.17192/z2017.0457.