Clinical Ophthalmology (Nov 2022)
Optical Coherence Tomography Can Predict Visual Acuity in Children with Optic Nerve Hypoplasia
Abstract
Athanasia Skriapa-Manta,1,2 Mattias Nilsson,1 Jan Svoboda,3 Monica Olsson,1,2 Maria Nilsson,4 Kristina Teär Fahnehjelm1,2 1Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; 2Department of Paediatric Ophthalmology, Strabismus and Electrophysiology, St. Erik Eye Hospital, Stockholm, Sweden; 3Department of Paediatric Radiology, Karolinska University Hospital, Stockholm, Sweden; 4Unit of Optometry, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenCorrespondence: Athanasia Skriapa-Manta, St Erik Eye Hospital, Eugeniavägen 12, Stockholm, 17164, Sweden, Tel +46 739 491 186, Email [email protected]: Optic nerve hypoplasia (ONH) is a common cause of visual impairment in children. Clinical complexity can cause diagnostic delay and difficulties predicting visual outcome. We evaluated whether optical coherence tomography (OCT) can improve the diagnosis and prediction of vision.Methods: Thirty-seven eyes with ONH from 12 girls and 8 boys, median age 10.5 years (range 2.8– 18.9 years), were included in this cross-sectional cohort study. The majority, 17/20, had bilateral ONH. Ophthalmological assessments included best corrected visual acuity (BCVA), fundus photography, measurement of the peripapillary retinal nerve fibre layer (pRNFL), macular ganglion cell complex (GCC), Bruch’s membrane opening (BMO) and visual fields. We compared OCT parameters with comparison data collected on 140 healthy individuals 5 to 25 years old. Pearson’s correlation coefficient was used to determine the correlation of OCT parameters and BCVA.Results: OCT demonstrated thinner mean pRNFL (p < 0.001) and mean GCC compared to the reference material (p < 0.001). BCVA displayed a strong or moderate correlation to pRNFL and to all sectors of the GCC except the inferotemporal. BCVA correlated strongly to Bruch’s membrane opening (BMO) (0.71, p < 0.001), and moderately to the Zeki ratio (− 0.52, p < 0.001). Multivariate analyses showed that BMO explained 48% of the variance in BCVA. Visual fields correlated strongly to pRNFL and GCC thickness. GCC thinning corresponded to visual field defects presence and location.Conclusion: OCT can facilitate the diagnosis of ONH. Parameters such as pRNFL, GCC and BMO can be predictors of visual acuity whereas GCC and pRNFL thinning can indicate location and severity of visual field defects.Keywords: optic nerve hypoplasia, OCT, ganglion cell complex, RNFL, visual fields, paediatric ophthalmology
