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Indian Journal of Clinical and Experimental Ophthalmology


OCT Normative Database of Macula in the Paediatric Population


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Author Details: Ojha Sushil, Jain Vaibhav, Sharma Reena, Singh Brijesh, Shukla Dipendra

Volume : 1

Issue : 4

Online ISSN : 2395-1451

Print ISSN : 2395-1443

Article First Page : 238

Article End Page : 244


Abstract

Purpose: Macular thickness parameters in normal paediatric population of central India.
Materials and Methods: This observational cross sectional study was conducted at UPRIMS AND R (Uttar Pradesh Rural Institute of Medical Sciences and Research) Saifai, Etawah to detect normative optical coherence tomography database for paediatric population in central Indian region. The total 70 of normal Indian children (eyes) after thorough ocular examination were enrolled from eye out patient department (OPD).
The macular thickness was measured using cirrus high definition optical coherence tomography (OCT)

 

Inclusion criteria

·   Children with normal 6/6 visual acuity,

·   Any child of any age 5- 17 years but cooperative for doing OCT

Exclusion criteria

·   Children with strabismus or amblyopia

·   family history of glaucoma

·   any hereditary eye disease

·   history of intraocular surgery or any kind of laser therapy,

·   mentally challenged children with neurological, metabolic, vascular disorders,

·   other systemic disease possibly affecting the eye, presence of a media opacity,

·   best corrected visual acuity of less than 6/9,

·   hypermetropia more than + 3D, myopia more than –5D, or astigmatism more than 2D were also excluded.

In most of the cases both eyes were examined, using OCT and selected for normative database calculation. We also further tried to analyse whether sex and different age subgroups had any significant difference or not.
The subjects enrolled had no ocular problems. The children came for routine eye examination in Ophthalmology OPD or paediatrics OPD or brother of patient or cousin of patient were enrolled when they met the inclusion and exclusion criteria.
The complete Ophthalmological examination was done in all children including BCVA (best corrected visual acuity), IOP (intraocular pressure by tonopen), anterior segment examination by slit lamp , assessment of squint by cover test, cover-uncover test and posterior segment examination under mydriasis  with slit lamp using 90D or Indirect ophthalmoscopy.
Dilatations of pupil were done with tropicamide 1% for posterior segment examination. If required cycloplegia was done using homatropine or cyclopentolate (1% or 2%).The macular thickness was then measured with OCT. The OCT machine used was Stratus OCT, software version 4.0.4, Carl Zeiss, Dublin, CA.

 

Results:
Demographics: 70 subjects consented for the study. Out of these 5 (7.1%) were uncooperative and scan could not be done in them. One(1) subject had leucomatous corneal opacity in the left eye. 12 (9.3%) scans out of 129 were excluded because of poor scan quality. So a total of 59 children (117 eyes) were included in statistical analysis there were 36 male and 23 females. Among the total children 28 children were between 5-10years age group and 31 were between 11-16 years age group.There was no statistically significant difference between male and female average macular thickness, despite having higher male in the study. (36 male and 23 female)
Macular thickness: The mean central macular thickness was 243.26± 22.136 μm(range was from 183µm-290µm. The mean macular thickness in males was 241.97 ± 22.773μm (range 219-264μm) and that in females was 239.70± 23.092 μm(range 216-262  μm). There was no statistical difference in the CMT in between males and females. This data has been shown in fig:4 (histogram). In regression analysis, it was found that in between 5-10 years age group mean CMT was 238.96± 20.723 μm (range was from260 μm -218μm) and between 11-16 years age group mean CMT was 243.00± 24.576 μm ( range was from 267μm -218μm) but this had no statistically significant (P =0.0702) effect on macular thickness.
The macular thickness was found to be greatest in nasal quadrant followed by superior, inferior and then temporal (table 1). Furthermore thickness was found to be more in the inner macular area (3 mm area).
Conclusion: In conclusion we analysed the normative database on OCT for for macular thickness in paediatric age in rural population of central India. The macular thickness noted in our study is comparable to that than reported in literature. The data obtained from the study would help in OCT evaluation for macular disorders. The Study would further help in characterising OCT scan to be normal or pathological if it lies outside the 2 standard deviation obtained in our study in children of central India.

Keywords:
Indian children, OCT, macular thickness