title: Optic Nerve Head Development in Healthy Infants and Children Using Handheld Spectral-Domain Optical Coherence Tomography.
abstract: To determine feasibility of optic nerve head (ONH) imaging and to characterize ONH development in full-term infants without sedation using handheld spectral-domain optical coherence tomography (SD OCT).
  
  
  
  Prospective cross-sectional study.
  
  
  
  Three hundred fifty-two children aged between 1 day and 13 years.
  
  
  
  All participants were imaged using handheld SD OCT without sedation during a single scan session. The percentage of successful scans was calculated. Interexaminer reproducibility and differences between right and left eyes were assessed using intraclass correlation coefficients (ICCs). Images were analyzed using ImageJ software. The developmental trajectories over time for ONH parameters were calculated using fractional polynomial modelling.
  
  
  
  Disc and cup diameter (expressed as distance in micrometers and visual angle in degrees), cup depth, Bruch's membrane opening-minimum rim width (BMO-MRW), retinal thickness, and retinal nerve fiber layer (RNFL; 1700 μm and 6° from the disc center).
  
  
  
  On average, 70% of participants were imaged successfully. Interexaminer reliability was excellent (ICC, >0.89) for diametric and retinal thickness parameters. Right and left eyes were similar for diametric measurements (ICC, >0.79), but more variable for nasal BMO-MRW, RNFL, and retinal thickness. The mean disc and cup diameter increase by 30% and 40%, respectively, between birth and 13 years of age when expressed as a distance measure, but remained constant (at 5°-5.5° and 2°, respectively) when expressed as a visual angle with reference to the eye nodal point. The peripapillary temporal RNFL demonstrated a marked initial decrease of nearly 35% between birth and approximately 18 months of age. This was followed by a slow increase up to 12 years of age when measured at 1700 μm from the disc center, although there was little change when measured at 6° from the disc center.
  
  
  
  We demonstrated feasibility of handheld SD OCT imaging of the ONH in full-term infants and children without anaesthesia or sedation. This is the first in vivo handheld SD OCT study to describe the development of ONH parameters during the critical early years of visual maturation. Our results provide a normative database for use in routine practice and further studies of ONH pathologic features.
authors: Ulverscroft Eye Unit, University of Leicester, Leicester, United Kingdom. Electronic address: ap552@le.ac.uk.
authors: Aarti
authors: A
authors: Patel
authors: Ulverscroft Eye Unit, University of Leicester, Leicester, United Kingdom.
authors: Ravi
authors: R
authors: Purohit
authors: Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Sir Henry Wellcome Laboratories, Southampton, United Kingdom.
authors: Helena
authors: H
authors: Lee
authors: Ulverscroft Eye Unit, University of Leicester, Leicester, United Kingdom.
authors: Viral
authors: V
authors: Sheth
authors: Ulverscroft Eye Unit, University of Leicester, Leicester, United Kingdom.
authors: Gail
authors: G
authors: Maconachie
authors: Department of Ophthalmology, University Hospital of Larissa, Mezourlo, Larissa, Greece.
authors: Eleni
authors: E
authors: Papageorgiou
authors: Ulverscroft Eye Unit, University of Leicester, Leicester, United Kingdom.
authors: Rebecca J
authors: RJ
authors: McLean
authors: Ulverscroft Eye Unit, University of Leicester, Leicester, United Kingdom.
authors: Irene
authors: I
authors: Gottlob
authors: Ulverscroft Eye Unit, University of Leicester, Leicester, United Kingdom.
authors: Frank A
authors: FA
authors: Proudlock
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009898:Optic Disk / Q000000981:diagnostic imaging / Q000254:growth & development*; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000166:cytology; D041623:Tomography, Optical Coherence / Q000295:instrumentation*