Macular Ganglion Cell and Retinal Nerve Fiber Layer Thickness in Children With Refractive Errors-An Optical Coherence Tomography Study

Purpose: To study the distribution of macular ganglion cell-inner plexiform layer (GC-IPL) thickness and peripapillary retinal nerve fiber layer (RNFL) thickness in children with refractive errors. Materials and Methods: Two hundred forty-three healthy eyes from 139 children with refractive error ranging from -10.00 to +5.00D were recruited from the National University Hospital Eye Surgery outpatient clinic. After a comprehensive ocular examination, refraction, and axial length (AL) measurement (IOLMaster), macular GC-IPL and RNFL thickness values were obtained with a spectral domain Cirrus high definition optical coherence tomography system (Carl Zeiss Meditec Inc.). Only scans with signal strength of >6/10 were included. Correlation between variables was calculated using the Pearson correlation coefficient. A multivariate analysis using mixed models was done to adjust for confounders. Results: The mean spherical equivalent refraction was -3.20 +/- 3.51D and mean AL was 24.39 +/- 1.72mm. Average, minimum, superior, and inferior GC- IPL were 82.59 +/- 6.29, 77.17 +/- 9.65, 83.68 +/- 6.96, and 81.64 +/- 6.70 mu m, respectively. Average, superior, and inferior peripapillary RNFL were 99.00 perpendicular to 11.45, 123.20 perpendicular to 25.81, and 124.24 +/- 22.23 mu m, respectively. Average, superior, and inferior GC-IPL were correlated with AL (beta = -2.056, P-value 0.000; beta = -2.383, P- value 0.000; beta = -1.721, P-value 0.000), but minimum GC- IPL was not (beta = -1.056, P-value 0.115). None of the RNFL parameters were correlated with AL. Conclusions: This study establishes normative macular GC- IPL and RNFL thickness in children with refractive errors. Our results suggest that high definition optical coherence tomography RNFL parameters and minimum GC-IPL are not affected by AL or myopia in children, and therefore warrants further evaluation in pediatric glaucoma patients.