Evaluation of Peripapillary and Macular Nerve Fiber Layer Thickness in Paediatric Glaucoma Suspects

Authors

  • Pragati Adhikari Gautam Lecturer, Department of Ophthalmology, B P Koirala Lions Center for Ophthalmic Studies, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal
  • Hira Nath Dahal Optomtery Instructor, Department of Ophthalmology, B P Koirala Lions Center for Ophthalmic Studies, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal
  • Jyoti Baba Shrestha Associate Professor, Department of Ophthalmology, B P Koirala Lions Center for Ophthalmic Studies, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal

DOI:

https://doi.org/10.3126/jnps.v42i2.42495

Keywords:

Ganglion cell complex, Pediatric glaucoma, Retinal nerve fiber layer, Spectral domain OCT

Abstract

Introduction: Glaucoma patients are known to have optic disc cupping, leading to loss of retinal ganglion cell axons. This peripapillary nerve thinness is known to be associated with glaucoma in adult patients. Hence, we intended to evaluate the peripapillary and macular nerve fiber thickness in eyes of pediatric glaucoma suspects using spectral domain optical coherence tomography (OCT).

Methods: This cross-sectional analytical study included 44 eyes of 22 paediatric glaucoma suspects, who were compared with 40 eyes of 20 normal paediatric eyes. Pearson correlation coefficients were calculated to assess the relations between the peripapillary retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC). Receiver Operating Characteristics (ROC) curve was plotted for OCT parameters in both the groups along with area under the curve (AUC) calculation. P values < 0.05 were considered as statistically significant.

Results: We found the RNFL to be thickest in the superior, inferior, nasal and temporal quadrants in both glaucoma suspects and normal group. When compared among quadrants in RNFL, all the values in different quadrants were statistically significant from each other and in between groups with p < 0.01. The RNFL thickness was statistically different in glaucoma when compared with normal in superior, temporal, and nasal quadrants however, no statistically significant difference was found in inferior quadrant RNFL. The largest AUC for discrimination of glaucoma suspect eyes from normal in peripapillary RNFL in was nasal quadrant in right eye, followed by temporal quadrant whereas it was largest in superior followed by nasal quadrants then average in left eye. However, AUC for discrimination of glaucoma suspects from normal in GCC was poor.

Conclusions: Glaucoma suspect paediatric eyes showed significant thinning in peripapillary nerve fiber layer thickness compared to normal subjects.

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Author Biographies

Hira Nath Dahal, Optomtery Instructor, Department of Ophthalmology, B P Koirala Lions Center for Ophthalmic Studies, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal

Instructor for B Optometry

Jyoti Baba Shrestha, Associate Professor, Department of Ophthalmology, B P Koirala Lions Center for Ophthalmic Studies, Maharajgunj Medical Campus, Tribhuvan University, Kathmandu, Nepal

Associate professor of Ophthalmology

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Published

2022-12-31

How to Cite

Adhikari Gautam, P., Dahal, H. N., & Shrestha, J. B. (2022). Evaluation of Peripapillary and Macular Nerve Fiber Layer Thickness in Paediatric Glaucoma Suspects. Journal of Nepal Paediatric Society, 42(2), 30–35. https://doi.org/10.3126/jnps.v42i2.42495

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Original Articles