Concept Library

Optical coherence tomography (OCT) provides structural information that facilitates early diagnosis, informs assessment of disease severity, guides management decisions, and enables longitudinal follow-up across pediatric eye diseases, including prematurity-related pathology, congenital optic disc anomalies, foveal hypoplasia, optic neuropathies, glaucoma, retinal vascular and inflammatory disorders, inherited retinal dystrophies, ocular tumors, and neuro-ophthalmic conditions.

Quantitative retinal thickness analysis in 27 patients with genetically confirmed Mucopolysaccharidosis type III (median age 6.5 years, range 1-16 years) showed median values at the lower end of the reference spectrum in the inner perifoveal ring and below the normal range in the outer perifoveal ring, with no distinct pattern distinguishing subtypes or phenotypes, in a retrospective monocenter case series.

One patient with Mucopolysaccharidosis type IIIA (out of 16 MPS IIIA patients) showed severe foveal atrophy, and another presented with foveal intraretinal fluid accumulation, in a retrospective monocenter case series of 27 patients with genetically confirmed MPS III.

Foveal thickening of the external limiting membrane was noted in 67% of patients with genetically confirmed Mucopolysaccharidosis type III (n = 27, median age 6.5 years, range 1-16 years) in a retrospective monocenter case series.

Parafoveal degeneration of the outer retinal layers was observed in 59% of patients with genetically confirmed Mucopolysaccharidosis type III (n = 27, median age 6.5 years, range 1-16 years) in a retrospective monocenter case series.

In a posthoc cohort analysis from a multicenter randomized controlled trial in the United States (NCT00212134) involving 110 participants with unilateral congenital cataract who underwent cataract surgery between 2004 and 2007 and were followed for 10.5 years, logistic regression models found shallower anterior chamber depth (ACD) was a strong predictor of glaucoma (OR 5.8 [1.8, 18.9], P = .004) at 10.5 years following congenital cataract surgery.

In a posthoc cohort analysis from a multicenter randomized controlled trial in the United States (NCT00212134) involving 110 participants with unilateral congenital cataract who underwent cataract surgery between 2004 and 2007 and were followed for 10.5 years, subjects diagnosed with glaucoma had an anterior chamber depth (ACD) of 2.76 ± 0.48 mm compared to 3.08 ± 0.38 mm among subjects without glaucoma or glaucoma suspect (mean difference = 0.32 mm, P = .003).

The prevalence of primary congenital glaucoma (PCG) was significantly higher in patients with fibrous ingrowth (FI-CSR group) (8/12 [66.7%]) compared to those without abnormal ingrowth (CSR group) (11/28 [39.3%] cases, P < 0.001) undergoing capsulectomy shunt revision (CSR) for failed Ahmed Glaucoma Valves (AGVs).

Bilateral optic nerve head OCT imaging using both the Spectralis (Heidelberg Engineering) and handheld Envisu C2300 (Leica Microsystems) devices achieved 100% imaging success in 20 children aged 4-18 years with craniosynostosis.

The coefficient of variation (CoV) for all quantitative cup, disc, rim, and peripapillary parameters derived from Spectralis (Heidelberg Engineering) and handheld Envisu C2300 (Leica Microsystems) OCT devices in children with craniosynostosis was low.

Intraclass correlation coefficients (ICC) for quantitative cup, disc, rim, and peripapillary parameters derived from Spectralis (Heidelberg Engineering) and handheld Envisu C2300 (Leica Microsystems) OCT devices in children with craniosynostosis were good-to-excellent, ranging from 0.81 to 1.00.

Optical coherence tomography (OCT) imaging of the optic nerve in school-aged children with craniosynostosis is comparable between the Spectralis (Heidelberg Engineering) and handheld Envisu C2300 (Leica Microsystems) OCT devices.

Optical coherence tomography (OCT) imaging of the optic nerve is feasible in school-aged children with craniosynostosis.

The 360-degree trabeculotomy group showed a reduction in failure rate with an Odds Ratio (OR) of 0.18 (0.11-0.31; P<0.0001, I²=14%) compared to the traditional angle surgery group in primary congenital glaucoma.

The 360-degree trabeculotomy group showed a higher qualified success rate with an Odds Ratio (OR) of 3.00 (1.47-6.12; P=0.003, I²=46%) compared to the traditional angle surgery group in primary congenital glaucoma.

The 360-degree trabeculotomy group showed a higher complete success rate with an Odds Ratio (OR) of 5.07 (3.43-7.50; P<0.0001, I²=4%) compared to the traditional angle surgery group in primary congenital glaucoma.

360-degree trabeculotomy showed a significant reduction in the number of anti-glaucoma medications by -0.47 drops (-0.69, -0.25; P<0.0001, I²=55%) compared to traditional angle surgery in primary congenital glaucoma.

360-degree trabeculotomy showed a significant reduction in intraocular pressure (IOP) by -2.10 mmHg (-3.26, -0.94; P=0.0004, I²=55%) compared to traditional angle surgery in primary congenital glaucoma.

A retrospective study comparing the Paul Glaucoma Implant (PGI) and the Ahmed Glaucoma Valve (AGV) in 14 eyes from 12 children (0-17 years) with glaucoma following congenital cataract surgery (GFCS) found no serious complications in either group at one-year follow-up.

A retrospective study of children aged 0-17 years with glaucoma following congenital cataract surgery (GFCS) reported that complete or qualified surgical success was achieved in 85.7% of eyes in the Ahmed Glaucoma Valve (AGV) group and 100% of eyes in the Paul Glaucoma Implant (PGI) group at one-year follow-up.

In a retrospective study of children aged 0-17 years with glaucoma following congenital cataract surgery (GFCS), the median medication use decreased from 3 (IQR 0) to 0 (IQR 1) in the Ahmed Glaucoma Valve (AGV) group and from 4 (IQR 1) to 2 (IQR 2) in the Paul Glaucoma Implant (PGI) group at one-year follow-up.

A retrospective study of children aged 0-17 years with glaucoma following congenital cataract surgery (GFCS) found that the mean intraocular pressure (IOP) decreased significantly in both the Ahmed Glaucoma Valve (AGV) group (from 26.7±5.2 to 14.4±3.0 mmHg) and the Paul Glaucoma Implant (PGI) group (from 30.4±9.7 to 12.6±4.5 mmHg) at one-year follow-up, with no significant intergroup difference.

Angle abnormalities identified during the annotation of swept-source anterior segment optical coherence tomography (SS-ASOCT) images in patients undergoing congenital cataract surgery were associated with poorer visual outcomes.

Multivariable analysis in secondary pseudophakic eyes (S-PsE) following congenital cataract surgery revealed that nasal AOD500 (β = -0.685, P < 0.05) and nasal TIA500 (β = -0.109; P < 0.001) showed negative associations with intraocular pressure, while corneal thickness positively correlated with IOP.

Both primary and secondary pseudophakic eyes (P-PsE and S-PsE) following congenital cataract surgery exhibited significant postoperative reductions in ARA500 and TISA500 (P < 0.05), mainly in the nasal angle, after intraocular lens implantation.

Aphakic eyes, following congenital cataract surgery, showed larger AOD500 and ARA500 but smaller TISA500 compared to normal eyes (P < 0.05).

Optical coherence tomography (OCT) serves as a valuable tool for disease monitoring, particularly in NF1 pediatric patients with optic pathway gliomas.

NF1-associated optic pathway gliomas exhibited a more indolent disease course, lower treatment rates, and preserved vision despite retinal nerve fiber layer thinning.

Among non-NF1 pediatric patients with optic pathway gliomas, chemotherapy was associated with worse final visual acuity (LogMAR 0.35 vs 0.06; P = .007) and more pronounced retinal nerve fiber layer thinning.

Retinal nerve fiber layer (RNFL) thickness declined in both NF1 and non-NF1 pediatric patients with optic pathway gliomas, but more prominently in non-NF1 eyes (99.9 to 75.5 m; P = .0019) compared with NF1 eyes (73.0 to 70.4 m; P = .0202).

Overall visual acuity (LogMAR) improved in pediatric patients with optic pathway gliomas, with non-NF1 eyes showing significant improvement (LogMAR 0.28 to 0.21; P = .0077), while NF1 eyes showed a nonsignificant trend (LogMAR 0.27 to 0.18; P = .0768).

Treatment was significantly more common in non-NF1 pediatric patients with optic pathway gliomas compared to NF1 patients, with surgery (69.2% vs 5%), chemotherapy (67.3% vs 25%), and radiation (30.8% vs 5%) (all P < .001).

An optimal papilledema (PE) screening threshold of ≥5.43 mm³ for optic nerve head volume (ONHV), determined by ROC analysis (AUC = 0.855), provides 73% sensitivity and 90% specificity for distinguishing PE from pseudopapilledema (PPE) in pediatric patients.

An optimal papilledema (PE) screening threshold of ≥163 μm for retinal nerve fiber layer (RNFL) thickness, determined by ROC analysis (AUC = 0.908), provides 78% sensitivity and 93% specificity for distinguishing PE from pseudopapilledema (PPE) in pediatric patients.

Retinal folds (RFs) demonstrated higher sensitivity (79.2%) but lower specificity (67.4%) for distinguishing papilledema (PE) from pseudopapilledema (PPE) in pediatric patients, while peripapillary wrinkling (PPW) showed higher specificity (92.9%) and lower sensitivity (43.5%).

Retinal folds (RFs) or peripapillary wrinkling (PPW) were observed in 90.2% of papilledema (PE) eyes and 38.6% of pseudopapilledema (PPE) eyes (P < 0.0001) in pediatric patients.

Peripapillary wrinkling (PPW) is specific to papilledema (PE) in pediatric patients and serves as an excellent rule-in tool, exhibiting a specificity of 92.9% and a sensitivity of 43.5% in distinguishing PE from pseudopapilledema (PPE).

Sutureless scleral-fixated intraocular lenses (SLSFIOLs) and Gore-Tex sutured scleral-fixated intraocular lenses (SSFIOLs) have low complication rates in children, according to a meta-analysis of 33 studies (1531 eyes) aged 1-18 years.

Glued scleral-fixated intraocular lenses (GSFIOLs) had a 5.3% reoperation rate, mostly for IOL repositioning, in a meta-analysis of 33 studies (1531 eyes) of children aged 1-18 years.

A suture break or erosion was reported in 1.19% of cases across all types of scleral-fixated intraocular lenses (SFIOLs), with no suture erosion reported in Gore-Tex sutured scleral-fixated intraocular lenses (SSFIOLs), in a meta-analysis of 33 studies (1531 eyes) of children aged 1-18 years.

Polypropylene sutured scleral-fixated intraocular lenses (SSFIOLs) had a glaucoma rate of 0.31% and corneal decompensation rate of 0.15% in a meta-analysis of 33 studies (1531 eyes) of children aged 1-18 years.

Transient high intraocular pressure (IOP) post-operatively was highest among polypropylene sutured scleral-fixated intraocular lenses (SSFIOLs) at 8.1% in a meta-analysis of 33 studies (1531 eyes) of children aged 1-18 years.

Vision improved from preoperative (mean 0.75±0.50 SD) to postoperative (mean 0.39±0.19 SD) logarithm of the minimal angle of resolution across all types of scleral-fixated intraocular lenses (SFIOLs) in a meta-analysis of 33 studies (1531 eyes) of children aged 1-18 years.