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Bulgarian Review of Ophthalmology

Investigation of retinal nerve fiber layer thickness and its physiological asymmetry in healthy children and adults with Topcon OCT

B. Mihaylova


Purpose: To investigate mean peripapillary retinal nerve fiber layer (RNFL) and parameters of macula for glaucoma analysis (RNFL Thickness, GCL+, GCL++) with Topcon 3D OCT 2000+ in healthy children and adults and to determine their physiological asymmetry between the right and left eye, as well as its change with age. To study the effects of axial length (Ax) and Disc area on RNFL thickness and macular parameters.

Material and methods: In this study 420 eyes of 210 patients aged 7-85 years were enrolled. All of them were examined in the Department of Ophthalmology, Medical University Alexandrovska Hospital, Sofia for period of 09.2014-08.2015. Patients are divided into 4 groups by age and 1 group RNFL-Ax-Disc area. All of them underwent optical coherence tomography - 3D Disc, Circle, Macula Glaucoma Analysis. In order to evaluate the physiological asymmetry intraclass correlation coefficients were introduced.

Results: Peripapillary RNFL is thickest in the group of children. With age RNFL thickness tends to get smaller. Statistically significant differences in RNFL thickness between the group of children and young adults are found only in two segment parameters. Physiologic asymmetry in RNFL thickness between the right and left eye increases with age, the larger loss of nerve fibers in the left eye. Pearson`s analysis showed a negative correlation of the RNFL/macular parameters with Ax, and positive correlation of RNFL/macular parameters with Disc area. There is no correlation of the macular RNFL thickness with Ax/DiscArea.

Conclusions: The color results in children protocols could be considered reliable for the diagnostic assessment of the clinicians, despite the absence of a normative database for individuals under 18 years of age. The asymmetry of retinal parameters might be valuable in assessing certain early diseases. Physiological asymmetry increases with age and this should come into consideration, when clinicians examine patients with different ages.


peripapillary nerve fiber layer; children; Topcon 3D OCT; physiological asymmetry; axial length; disc area

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About The Author

B. Mihaylova
Department of Ophthalmology, Medical University - Sofia, Alexandrovska University Hospital, Sofia