Spectral domain optical coherence tomography in children operated for primary congenital glaucoma.

AIM: To evaluate optic nerve head, retinal nerve fibre layer (RNFL) and ganglion cell complex (GCC) thickness measurements in children operated for primary congenital glaucoma (PCG) using spectral domain optical coherence tomography (SDOCT).

METHODS: In a case-control study, 45 eyes of 37 children operated for PCG and 72 eyes of 41 normal children underwent optic nerve head, RNFL and GCC imaging with SDOCT. Differences in SDOCT parameters between PCG and control group, correlation between SDOCT parameters and a range of clinical variables, namely preop corneal diameter, intraocular pressure, degree of corneal oedema and age at which surgery was performed in PCG eyes, were evaluated.

RESULTS: Mean (±SD) age of children in PCG group was 10.1±3.6 years and control group was 13.6±3.2 years (p<0.001) at the time of SDOCT imaging. Visual fields, whenever possible were unreliable in 20 of 23 PCG and 30 of 46 normal eyes. All SDOCT parameters were significantly different (p<0.001) in PCG compared with control group. All global SDOCT parameters (rim area, average RNFL and GCC thickness) correlated significantly with the clinical cup to disc ratio measurements (correlation coefficients better than -0.70) in children with PCG. Age at which surgery was performed was inversely related to SDOCT parameter thickness but was not statistically significant.

CONCLUSIONS: All SDOCT parameters were significantly different in children operated for PCG compared with normal children. Future research should evaluate the test-retest variability of SDOCT and its ability to diagnose progression in children unable to perform reliable visual field tests.