title: Reproducibility of circumpapillary retinal nerve fiber layer measurements using handheld optical coherence tomography in sedated children.
abstract: OBJECTIVE
  To determine the intra- and intervisit reproducibility of circumpapillary retinal nerve fiber layer (RNFL) measures using handheld optical coherence tomography (OCT) in sedated children.
  
  
  METHODS
  Prospective cross-sectional and longitudinal study.
  
  
  METHODS
  Children undergoing sedation for a clinically indicated magnetic resonance imaging for an optic pathway glioma and/or neurofibromatosis type 1 (NF1) had multiple 6 × 6 mm volumes (isotropic 300 × 300 or nonisotropic 1000 × 100 samplings) acquired over the optic nerve. Children with 2 handheld OCT sessions within 6 months were included in the intervisit cohort. The intra- and intervisit coefficient of variation (CV) and intraclass correlation coefficient (ICC) were calculated for the average and anatomic quadrant circumpapillary RNFL thickness.
  
  
  RESULTS
  Fifty-nine subjects (mean age 5.1 years, range 0.8-13.0 years) comprised the intravisit cohort and 29 subjects (mean age 5.7 years, range 1.8-12.7 years) contributed to the intervisit cohort. Forty-nine subjects had an optic pathway glioma and 10 subjects had NF1 without an optic pathway glioma. The CV was comparable regardless of imaging with an isotropic and nonisotropic volume in both the intra- and intervisit cohorts. The average circumpapillary RNFL demonstrated the lowest CV and highest ICC compared to the quadrants. For the intervisit cohort, the average ICC was typically higher while the CV was typically lower, but not statistically different compared to the other quadrants.
  
  
  CONCLUSIONS
  Circumpapillary RNFL measures acquired with handheld OCT during sedation demonstrate good intra- and intervisit reproducibility. Handheld OCT has the potential to monitor progressive optic neuropathies in young children who have difficulty cooperating with traditional OCT devices.
authors.affiliation: The Gilbert Family Neurofibromatosis Institute, Children's National Health System, Washington, DC; Department of Neurology, Children's National Health System, Washington, DC; Department of Ophthalmology, Children's National Health System, Washington, DC; Department of Pediatrics, Children's National Health System, Washington, DC; Center for Neuroscience and Behavior, Children's National Health System, Washington, DC. Electronic address: ravery@childrensnational.org.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Avery
authors.affiliation: The Gilbert Family Neurofibromatosis Institute, Children's National Health System, Washington, DC; Division of Biostatistics and Study Methodology, Children's National Health System, Washington, DC.
authors.forename: Avital
authors.initials: A
authors.lastname: Cnaan
authors.affiliation: UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Joel S
authors.initials: JS
authors.lastname: Schuman
authors.affiliation: UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Chieh-Li
authors.initials: CL
authors.lastname: Chen
authors.affiliation: The Gilbert Family Neurofibromatosis Institute, Children's National Health System, Washington, DC.
authors.forename: Natalie C
authors.initials: NC
authors.lastname: Glaug
authors.affiliation: The Gilbert Family Neurofibromatosis Institute, Children's National Health System, Washington, DC; Department of Neurology, Children's National Health System, Washington, DC; Department of Pediatrics, Children's National Health System, Washington, DC; Center for Neuroscience and Behavior, Children's National Health System, Washington, DC; The Brain Tumor Institute, Children's National Health System, Washington, DC.
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Packer
authors.affiliation: Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Graham E
authors.initials: GE
authors.lastname: Quinn
authors.affiliation: UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishikawa
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D009456:Neurofibromatosis 1 / Q000175:diagnosis*; D009898:Optic Disk / Q000473:pathology*; D020339:Optic Nerve Glioma / Q000175:diagnosis*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000295:instrumentation*