Comparison of Optic Disc Parameters in Hyperopic and Emmetropic Eyes of Healthy Children with HRT and OCT

Abstract

Purpose To investigate, through Heidelberg retina tomography II (HRT II) and RTVue-100 optical coherence tomography (OCT), normal parameters of the optic nerve head (ONH) in highly hyperopic children, and compare these with a group of children with low hyperopia and emmetropia, as fundus examination of highly hyperopic children often shows crowding of the optic disc, which may be difficult to distinguish from mild optic disc swelling.

Patients and Methods ONH of the higher hyperopic eye was examined with HRT II and the peripapillary nerve fiber layer (RNFL) with RTVue-100, in 6 to 15-year-old full-term children with normal visual acuity and spherical equivalent ≥ + 3.0 D (hyperopic group) and < + 3.0 to − 1.0 D (emmetropic group).

Results Thirty highly hyperopic children and 33 emmetropic controls had a mean spherical equivalent of + 5.1 ± 1.5 D and a mean age of 8.4 ± 2.8 years, and + 1.0 ± 1.2 D and 9.6 ± 2.6 years, respectively. There was no significant difference in OCT-assessed RNFL thickness between the two groups. Compared to the emmetropic group, following HRT parameters were significantly smaller in the hyperopic group: Disc area (1.41 vs. 1.68 mm², p = 0.023), cup area (0.19 vs. 0.37 mm², p = 0.0001), cup volume (0.03 vs. 0.08 mm³, p = 0.02), cup/disc area (0.13 vs. 0.20, p = 0.006), linear cup/disc (0.33 vs. 0.42, p = 0.004), and mean cup depth (0.13 vs. 0.17 mm, p = 0.019).

Conclusion In children, ONH of highly hyperopic eyes are smaller than those of emmetropic eyes. RNFL thickness and neural rim volume are similar to emmetropic eyes. They can therefore appear more crowded.

Zusammenfassung

Ziel Funduskopisch zeigt die Papille bei hoch hyperopen Kindern häufig eine leichte Prominenz, sodass im Einzelfall die Abgrenzung gegenüber einer milden Papillenschwellung schwierig sein kann. Ziel der vorliegenden prospektiven Studie war es daher, verschiedene Sehnervenparameter mit dem HRT-II und RTVue-100-OCT in normalsichtigen hoch hyperopen Kindern zu evaluieren und sie mit emmetropen Kindern zu vergleichen.

Patienten und Methode Mittels HRT-II und RTVue-100-OCT wurden die peripapilläre Nervenfaserschicht und verschiedene Papillenparameter bei 6 – 15 Jahre alten normalgeborenen Kindern mit Visus ≥ 0,8 und sphärischem Äquivalent ≥ + 3,0 dpt (Gruppe: Hyperopie) und < + 3,0 bis − 1,0 dpt (Gruppe: Emmetropie) erhoben. Das jeweils höher hyperope Auge wurde in die Studie eingeschlossen.

Ergebnisse Es wurden 63 Kinder eingeschlossen, hiervon wiesen 30 Kinder eine hohe Hyperopie auf. Das mittlere sphärische Äquivalent (SÄ) der hyperopen Kinder lag bei + 5,1 ± 1,5 dpt, der emmetropen Kinder bei + 1,0 ± 1,2 dpt. Die hyperopen Probanden waren im Durchschnitt 8,4 ± 2,7 und die emmetropen 9,6 ± 2,6 Jahre alt. Die OCT-Daten zeigten keinen signifikanten Unterschied in der peripapillären Nervenfaserschichtdicke zwischen beiden Gruppen. Folgende HRT-Parameter der Papille waren signifikant kleiner bei Probanden mit hoher Hyperopie als bei emmetropen Probanden: Papillenfläche (1,41 vs. 1,68 mm², p = 0,023), Exkavationsfläche (0,19 vs. 0,37 mm², p = 0,0001), Exkavationsvolumen (0,03 vs. 0,08 mm³, p = 0,02), lineare CDR (0,33 vs. 0,42, p = 0,004), Flächenquotient CDR (0,13 vs. 0,20, p = 0,006) und mittlere Exkavationstiefe (0,13 vs. 0,17 mm, p = 0,019). Alle übrigen HRT-Parameter unterschieden sich nicht signifikant.

Schlussfolgerung Papillen in hoch hyperopen gesunden Augen können funduskopisch prominenter erscheinen, da sie im Vergleich zu emmetropen Augen im Diameter kleiner sind. Sie weisen jedoch vergleichbare RNFL und Randsaumvolumen zu gesunden emmetropen Kindern auf.

Key words

children - optic nerve - HRT - OCT - hyperopia

Schlüsselwörter

Kinder - Papille - HRT - OCT - Hyperopie

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