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ORIGINAL RESEARCH article

Front. Ophthalmol.
Sec. Pediatric Ophthalmology and Strabismus
Volume 4 - 2024 | doi: 10.3389/fopht.2024.1479286

Cup-to-disc ratio measured clinically and via OCT in pediatric patients being monitored as glaucoma suspects for suspicious optic discs

Provisionally accepted
Caroline M. Zimmermann Caroline M. Zimmermann 1*Nur Cardakli Nur Cardakli 2Courtney L. Kraus Courtney L. Kraus 2
  • 1 Department of Ophthalmology and Visual Sciences, Univeristy of Maryland, Baltimore, United States
  • 2 Wilmer Eye Institute, School of Medicine, Johns Hopkins Medicine, Baltimore, Maryland, United States

The final, formatted version of the article will be published soon.

    Purpose: Compare cup-to-disc ratio (CDR) measured by clinical assessment and optical coherence tomography (OCT) in pediatric eyes being monitored as glaucoma suspects for suspicious optic disc appearance.Methods: An institutional study following 221 eyes from 122 unique pediatric glaucoma suspects being monitored due to increased or asymmetric appearance of CDR.Ophthalmologic findings, including visual acuity, intraocular pressure, CDR measured by clinical assessment, average retinal nerve fiber layer thickness, and average CDR measured by OCT, were recorded for each participant's initial and final examinations.CDRs measured clinically and by OCT were compared at both initial and final presentations.Results: Average age at presentation was 9.0 years old (95% CI: 8.0-9.9), and mean length of follow-up was 5.0 years (95% CI: 5.4-4.5). At initial presentation, 53 eyes had CDRs recorded by both clinical assessment and OCT, and at final presentation, 93 eyes had CDRs measured by both modalities. CDR measured by OCT was significantly larger than CDR measured clinically on initial and final presentation (p=0.002, p<0.001).Conclusions: Measurements of CDR by clinician assessment were significantly smaller than measurements obtained via OCT imaging. However, the average difference between CDR measured clinically and by OCT was <0.1. Thus, OCT may be a suitable way to measure CDR in pediatric glaucoma suspects, especially when clinical exam proves difficult. Further research is needed to assess CDR in glaucoma suspects using OCT longitudinally and in the context of other optic disc measurements, such as disc area.

    Keywords: Cup-to-disc ratio, Glaucoma suspect, Pediatric glaucoma, Optical coherence tomogaphy, pediatric

    Received: 11 Aug 2024; Accepted: 04 Nov 2024.

    Copyright: © 2024 Zimmermann, Cardakli and Kraus. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Caroline M. Zimmermann, Department of Ophthalmology and Visual Sciences, Univeristy of Maryland, Baltimore, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.