Cesk Slov Oftalmol. 2021 Spring;77(2):80-86. doi: 10.31348/2021/11.
The aim of this retrospective study is to compare two methods of optic disc drusen imaging in pediatric patients - new swept source OCT technology with the B-scan ultrasonography, which has been assumed to be a gold standard in diagnosing optic disc drusen, and to compare pRNFL thickness in children with optic disc drusen and control group.
14 eyes of 8 pediatric patients in whom optic disc drusen were confirmed by either B-scan ultrasonography, or swept-source OCT, were included in the study. We compared the sensitivity of these two imaging methods. Then we compared an average pRNFL thickness and pRNFL thickness in all four quadrants of our study group with the control group. Two statistical methods were used in data analysis - Mann-Whitney a Kruskal-Wallis test.
The difference between SS-OCT and B-scan ultrasonography was not statistically significant in diagnosing optic disc drusen. Average pRNFL thickness was 135.29 ± SD 31.2 μm in eyes with optic disc drusen, which is 24.15 % higher than in control group (p = 0.00214; p = 0.00207). pRNFL thickness of temporal (p = 0.0001; p = 0.0001), superior (p = 0.03486; p = 0.03361) and inferior (p = 0.00652; p = 0.00627) quadrant was statistically significantly higher in comparison with healthy controls, whereas the difference of pRNFL thickness in nasal quadrant was not statistically significant between the study and control group (p = 0.09692; p = 0.0947).
Swept source OCT is a promising new "gold standard" in optic disc drusen diagnostics in pediatric patients. An increase in pRNFL thickness values does not always confirm papilloedema as optic disc drusen may be the cause. Direct visualisation of optic disc drusen by swept source OCT can aid in differentiation from true papilloedema.
本回顾性研究旨在比较两种小儿视神经盘玻璃膜疣成像方法——新型扫频源光学相干断层扫描技术（SS-OCT）与被认为是诊断视神经盘玻璃膜疣“金标准”的 B 型超声扫描，比较视神经盘玻璃膜疣患儿与对照组的视网膜神经纤维层（pRNFL）厚度。
纳入经 B 型超声扫描或扫频源 OCT 证实存在视神经盘玻璃膜疣的 8 例患儿的 14 只眼，比较两种成像方法的敏感性。然后，我们比较了研究组与对照组的平均 pRNFL 厚度和四个象限的 pRNFL 厚度。数据分析采用两种统计学方法——Mann-Whitney 检验和 Kruskal-Wallis 检验。
SS-OCT 与 B 型超声扫描在诊断视神经盘玻璃膜疣方面无统计学差异。视神经盘玻璃膜疣眼的平均 pRNFL 厚度为 135.29±31.2μm，比对照组高 24.15%（p=0.00214；p=0.00207）。与对照组相比，颞侧（p=0.0001；p=0.0001）、上侧（p=0.03486；p=0.03361）和下侧（p=0.00652；p=0.00627）象限的 pRNFL 厚度均有统计学显著升高，而鼻侧象限的 pRNFL 厚度差异无统计学意义（p=0.09692；p=0.0947）。
扫频源 OCT 是小儿视神经盘玻璃膜疣诊断的一种很有前途的新“金标准”。pRNFL 厚度值的增加并不总是能证实视乳头水肿，因为视神经盘玻璃膜疣也可能是其原因。扫频源 OCT 对视神经盘玻璃膜疣的直接可视化有助于与真正的视乳头水肿相区别。
