Driessen Caroline, Eveleens Jordi, Bleyen Isabel, van Veelen Marie-Lise, Joosten Koen, Mathijssen Irene
Department of Plastic, Reconstructive and Hand Surgery, Dutch Craniofacial Centre, Erasmus MC Sophia Children's Hospital, Sk-1202, Post office box 2060, 3000, CB, Rotterdam, The Netherlands,
Childs Nerv Syst. 2014 Jun;30(6):1067-73. doi: 10.1007/s00381-014-2376-9. Epub 2014 Feb 12.
Our aim was to evaluate if optical coherence tomography (OCT) can be used as an alternative for fundoscopy to screen for increased intracranial pressure (ICP) in children with craniosynostosis
We performed a prospective cohort study at the Dutch Craniofacial Centre. We included 38 patients with nonsyndromic scaphocephaly and Crouzon's syndrome aged 3-8 years old, in whom we scored complaints suggestive of increased ICP and performed fundoscopy and OCT. Main outcome measures total retinal thickness (TRT) which was measured on 58 OCT scans.
Forty-three percent of fundoscopies revealed pathologic changes of the papil in at least one eye. Retinal thickness was increased in patients with an abnormal fundoscopy as compared to patients with a normal papil (TRT p < 0.001). Patients with Crouzon's syndrome had a significantly increased retinal thickness as compared to patients with scaphocephaly (TRT p < 0.001).
The current study demonstrates that OCT in children with craniosynostosis is feasible. It confirms that retinal thickness increases in case of papilledema. Given the quantitative character, OCT has a high potential as an alternative tool to screen for papilledema in craniosynostosis and other pediatric populations.
我们的目的是评估光学相干断层扫描（OCT）是否可作为眼底镜检查的替代方法，用于筛查颅缝早闭患儿的颅内压（ICP）升高情况。
我们在荷兰颅面中心进行了一项前瞻性队列研究。我们纳入了38例年龄在3至8岁之间的非综合征性舟状头畸形和克鲁宗综合征患者，对他们进行了提示ICP升高的症状评分，并进行了眼底镜检查和OCT检查。主要观察指标是在58次OCT扫描上测量的总视网膜厚度（TRT）。
43%的眼底镜检查显示至少一只眼睛的视乳头有病理改变。与视乳头正常的患者相比，眼底镜检查异常的患者视网膜厚度增加（TRT p < 0.001）。与舟状头畸形患者相比，克鲁宗综合征患者的视网膜厚度显著增加（TRT p < 0.001）。
目前的研究表明，OCT在颅缝早闭患儿中是可行的。它证实了视乳头水肿时视网膜厚度会增加。鉴于其定量特性，OCT作为筛查颅缝早闭和其他儿科人群视乳头水肿的替代工具具有很大潜力。
