Evaluating retinal thickness classification in children: A comparison between pediatric and adult optical coherence tomography databases

PURPOSE: This study investigates the agreement of children's retinal thickness classification by color category between Topcon 3D OCT-1's built-in adult reference data and our new pediatric database and assesses the correlation of retinal thickness with age and spherical equivalent (SE).

METHODS: 160 eyes of 160 healthy children (74 boys, 86 girls) aged 6-18 years (mean: 11.60 ± 3.28 years) were evaluated in this cross-sectional study. The peripapillary retinal nerve fibre layer (pRNFL) and macular thickness were determined for the 1st, 5th, 95th, and 99th percentile points. Cohen's κ value and specific agreement between pediatric data and adult reference database were estimated. The correlation between retinal thickness with age and SE was also determined.

RESULTS: The mean thickness for the total RNFL, average macular, and central macula were 112.05±8.65 μm, 280.24±12.46 μm, and 220.55±17.53 μm, respectively. The overall agreement between the classification of the adult database and pediatric data for pRNFL was ≥90%, with discrepancies in 46 out of 150 eyes (30.67%); for macula, it was above 72%, with discrepancies in 93 out of 153 eyes (60.78%); and for ganglion cell complex and ganglion cell + inner plexiform layer (GCIPL) the agreement was above 84% and 85%, respectively. A significant level of agreement between pediatric data and adult reference data was achieved for temporal RNFL (κ = 0.65), macular perifoveal superior (κ = 0.67), and inferior (κ = 0.63) and inferior GCIPL (κ = 0.67). The correlations between age and retinal thickness were not significant (all p>0.05). Most retinal thickness parameters were positively associated with SE (Pearson's coefficient, r = 0.26 to 0.49, all p<0.05).

CONCLUSIONS: The overall agreement for pRNFL and macular thickness measurements in children with the adult reference database was between 72% and 90%. Children's retinal thickness was not significantly correlated with age but was positively associated with spherical equivalent.