• Written By: Jeremy B. Wingard, MD

    This prospective study found that spectral domain optical coherence tomography (SD-OCT) parameters were significantly altered in eyes of children operated on for primary congenital glaucoma.

    To the authors’ knowledge, this is the first study to evaluate optic nerve head, retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness measurements using SD-OCT in children operated for primary congenital glaucoma. Adding to a few earlier studies, this research underscores the need for and potential utility of normative OCT databases for the pediatric population.

    The authors used SDOCT to examine 37 children (45 eyes) aged 5 to 18 years who were operated on for primary congenital glaucoma in their first year of life and 41 normal children (71 eyes). Mean age at the time of SD-OCT imaging was 10.1±3.6 years in the primary congenital glaucoma group and 13.6±3.2 years in the control group. Visual field tests, when taken, were unreliable in 20 of 23 study group eyes and 30 of 46 control eyes.

    All SDOCT parameters were significantly different in primary congenital glaucoma eyes compared with normal eyes. In primary congenital glaucoma eyes, all global parameters (rim area, average RNFL and GCC thickness) correlated significantly with the clinical cup-to-disc ratio measurements (correlation coefficients better than −0.70).

    They conclude that SD-OCT is a promising tool for evaluating children operated for PCG in whom visual fields are unreliable. Future research should examine the test-retest variability of SD-OCT parameters and their ability to diagnose progression in these children.