New study highlights need for pediatric-specific OCT databases

Using adult reference databases for optical coherence tomography (OCT) measurements in children can lead to significant misclassifications of peripapillary nerve fiber layer (pRNFL)  thickness, which may affect the accurate diagnosis and treatment of optic nerve conditions in pediatric patients, according to a study that emphasizes the need for pediatric-specific normative databases to ensure more accurate assessments.

The cross-sectional study, involving 126 healthy children, aimed to evaluate how well adult reference values translate to the pediatric population. Researchers assessed pRNFL thickness by comparing measurements using both pediatric and adult databases. They defined abnormal values as those below the 5th percentile (≤p5) or above the 95th percentile (>p95) of the reference range.

In the study, only 6.6% of pRNFL values deemed abnormal according to pediatric standards were classified as normal using adult reference values. Overall, 88% of values that were flagged as abnormal by adult standards were considered normal when assessed with pediatric criteria.

The study advocates for the development and use of pediatric-specific normative databases to enhance the accuracy of OCT measurements in children. With the current reliance on adult data, there’s a risk of misdiagnosis and potentially inadequate treatment for young patients.

Reference
Muñoz-Gallego A, Torres-Peña JL, Rodríguez-Salgado M, et al. Values of peripapillary retinal nerve fibre layer thickness are different in children and adults. Clin Exp Optom. 2024;1-9. doi: 10.1080/08164622.2024.2376199. Epub ahead of print. PMID: 39025791.