Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.
Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.
J AAPOS. 2024 Aug;28(4):103968. doi: 10.1016/j.jaapos.2024.103968. Epub 2024 Jul 8.
Handheld optical coherence tomography (HH-OCT) can image awake, young children but lacks integrated segmentation/analysis software. OCT imaging of eyes with optic neuropathies demonstrates ganglion cell layer (GCL) and ganglion cell complex (GCC) thinning, with a normal or thickened inner nuclear layer (INL). We compared pediatric normative data with GCL/INL and GCC/INL ratios from HH-OCT macular scans of awake young children with clinically diagnosed optic neuropathies.
Macular HH-OCT from awake children with optic neuropathies was prospectively obtained using Bioptigen (Leica Microsystems, Wetzlar, Germany). The GCL, GCC, and INL were manually measured by two readers using ImageJ from single-line macular scans at the thickest points nasal and temporal to the fovea, respectively, and the GCL/INL and GCC/INL ratios were calculated and compared with normative data.
HH-OCT images from 17 right eyes of 17 children (mean age, 4.3 ± 2.9 years) with optic neuropathies were analyzed. Mean nasal (17 eyes) and temporal (16 eyes) GCL/INL ratios with optic neuropathies were 0.44 ± 0.38 (95% CI, 0.26-0.62) and 0.26 ± 0.22 (95% CI, 0.15-0.36), respectively. Corresponding normative GCL/INL ratios are 1.26 ± 0.20 (95% CI, 1.19-1.34) and 1.23 ± 0.27 (95% CI, 1.13-1.33), respectively (P < 0.0001). Severe thinning precluded GCL measurements in 2 eyes nasally and 5 eyes temporally, resulting in GCL measurements of zero. Mean nasal (17 eyes) and temporal (16 eyes) GCC/INL ratios were 1.93 ± 0.70 (95% CI,1.60-2.27) and 1.67 ± 0.44 (95% CI,1.46-1.87). Corresponding normative ratios are 2.85 ± 0.38 (95% CI, 2.71-2.99) and 2.87 ± 0.42 (95% CI, 2.70-3.03), respectively (P < 0.0001).
GCL/INL and GCC/INL ratios calculated from single-line macular HH-OCT scans in awake young children with optic neuropathies differ significantly from normative values and may thus have utility in helping to establish a diagnosis of optic neuropathy.
手持式光学相干断层扫描（HH-OCT）可用于对清醒的幼儿进行成像，但缺乏集成的分割/分析软件。视神经病变患者的 OCT 成像显示神经节细胞层（GCL）和神经节细胞复合体（GCC）变薄，内核层（INL）正常或增厚。我们比较了清醒的患有视神经病变的幼儿的 HH-OCT 黄斑扫描的儿科正常值与 GCL/INL 和 GCC/INL 比值。
使用 Bioptigen（Leica Microsystems，Wetzlar，德国）前瞻性地获得了患有视神经病变的清醒儿童的黄斑 HH-OCT。使用 ImageJ 从分别位于黄斑最厚点鼻侧和颞侧的单一线条扫描中手动测量 GCL、GCC 和 INL，计算 GCL/INL 和 GCC/INL 比值，并与正常值进行比较。
分析了 17 名患有视神经病变的儿童（平均年龄 4.3 ± 2.9 岁）的 17 只右眼的 HH-OCT 图像。患有视神经病变的眼鼻侧（17 只眼）和颞侧（16 只眼）的平均 GCL/INL 比值分别为 0.44 ± 0.38（95%CI，0.26-0.62）和 0.26 ± 0.22（95%CI，0.15-0.36）。相应的正常 GCL/INL 比值分别为 1.26 ± 0.20（95%CI，1.19-1.34）和 1.23 ± 0.27（95%CI，1.13-1.33）（P < 0.0001）。2 只眼鼻侧和 5 只眼颞侧严重变薄，无法测量 GCL，导致 GCL 测量值为零。眼鼻侧（17 只眼）和颞侧（16 只眼）的平均 GCC/INL 比值分别为 1.93 ± 0.70（95%CI，1.60-2.27）和 1.67 ± 0.44（95%CI，1.46-1.87）。相应的正常比值分别为 2.85 ± 0.38（95%CI，2.71-2.99）和 2.87 ± 0.42（95%CI，2.70-3.03）（P < 0.0001）。
患有视神经病变的清醒幼儿的单一线条黄斑 HH-OCT 扫描计算的 GCL/INL 和 GCC/INL 比值与正常值有显著差异，因此可能有助于确立视神经病变的诊断。
