Evaluation of optic nerve head and retinal layers in affected and fellow eyes of pediatric glaucoma

Pediatric glaucoma is a rare disease that is potentially more severe than adult glaucoma because it is more challenging to diagnose and more difficult to treat. The segmented retinal layer has been shown to have excellent capability in assessing adult glaucoma. However, there is limited information regarding the benefits of spectral domain-optical coherence tomography (SD-OCT) in children. Thus, our study aims to investigate the role of circumpapillary (cp) OCT analysis in examining pediatric glaucoma and characterizing the changes in the fellow eyes of glaucomatous children. SD-OCT was used to investigate the optic nerve head (ONH) and retinal morphology of 18 patients with pediatric glaucoma and 14 matched healthy controls. As predicted, pediatric patients with glaucoma had a wider disk diameter, cup diameter, and cup-to-disk ratio (CDR). Pediatric glaucoma also resulted in a thinner retinal nerve fiber layer (RNFL), ganglion cell layer – inner plexiform layer (GCL-IPL), photoreceptor layer – retinal pigment epithelium (PRL-RPE), and total retinal layer (TRL). Similarly, these observations were found in the fellow eyes of glaucomatous children. Our finding also indicated that cpRNFL, GC-IPL, and PRL-RPE thickness were useful for the early identification of pediatric glaucoma. In conclusion, SD-OCT could be implemented in managing glaucoma in young children. Moreover, retinal layer damage at the corresponding locations of the fellow eye is similarly detected in the glaucomatous eye.