Measurement of macular thickness with optical coherence tomography: impact of using a paediatric reference database and
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PEDIATRICS
Measurement of macular thickness with optical coherence tomography: impact of using a paediatric reference database and analysis of interocular symmetry Alicia Muñoz-Gallego 1,2 & José L. Torres-Peña 1 & Martín Rodríguez-Salgado 3 & Ana Ortueta-Olartecoechea 1 & Cristina López-López 1 & Javier De la Cruz 4,5 & Pilar Tejada-Palacios 1,2,5 Received: 25 May 2020 / Revised: 11 August 2020 / Accepted: 16 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Optical coherence tomography (OCT) software is used to classify abnormality of macular thickness by colour category based on reference data from adult series. We assessed the impact of using paediatric reference thickness values for macular thickness instead of adult reference values. Methods Cross-sectional study. Primary and tertiary healthcare setting. Out of 140 healthy participants aged 5 to 18 years, 126 were eligible, 83% from European origin. Following a dilated eye examination and cycloplegic refraction, participants underwent macular scanning with OCT (Topcon 3D OCT-2000). Macular thickness paediatric reference values were recorded by spherical equivalent (SE) and sex, and the specific agreement between paediatric and adult reference values below or equal to percentile 5 and above percentile 95 was estimated. The absolute interocular differences for all macular parameters were determined. Results Multivariate regression analysis confirmed statistically independent positive associations between SE and average thickness, total volume, and temporal and inferior outer quadrants (all p values ≤ 0.003). The analysis also revealed higher values in males for average thickness, central thickness, and all inner macula quadrants (all p values ≤ 0.039). The use of the adult database only detected 49% of the extreme values (≤ p5 and > p95) in our paediatric sample. The 95th percentile limits for absolute interocular differences for all macular parameters ranged from 12 to 17 μm. Conclusions OCT-based macular reference values for paediatric SE and sex improve detection of children with abnormal macular thicknesses. Interocular differences exceeding standard references for macular parameters should be considered for further examinations. Keywords Optical coherence tomography . Macula . Fovea . Childhood . Children . Paediatric reference database
Introduction * Javier De la Cruz [email protected]; [email protected] 1
Ophthalmology Department, Madrid University Hospital “12 de Octubre”, Madrid, Spain
2
Madrid University Complutense, Madrid, Spain
3
Madrid Regional Health Service (SERMAS), Primary Health Care, Madrid, Spain
4
Spanish Mother & Child Health, and Development Research Network SAMID, Madrid, Spain
5
Madrid University Hospital “12 de Octubre”, Instituto de Investigación Sanitaria (imas12), CAA-6D. Avda. de Córdoba s/n, E-28041 Madrid, Spain
The fovea is the most important portion of the human retina in terms of visual acuity and colour vision [1]. The main advantage of spectral domain optic c
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