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Retinal Nerve Fiber Layer Analysis of Cupping in Children Born Prematurely

Purpose:The aim of this study was to quantitatively study the retinal nerve fiber layer (RNFL) thickness in children born prematurely with isolated optic nerve cupping. Patients and Methods:Six otherwise healthy premature children with clinical evidence of increased cup to disc ratios were enrolled in this observational case series. RNFL thickness was measured using Cirrus optical coherence tomography (OCT) optic disc cube 200×200 protocol and compared with age-matched normal controls using T test for statistical significance, with Bonferroni correction when appropriate. Results:Nerve fiber layer measurements showed a statistically significant decrease in overall RNFL. Superior quadrant RNFL thinning was statistically significant and inferior, nasal, and temporal nerve fiber layer thickness was decreased, although results were not statistically significant. Conclusions:Nerve fiber layer thinning in children born prematurely showing enlarged cup to disc ratios appears more consistent with optic nerve hypoplasia than glaucoma, as reflected by the markedly decreased average nerve fiber layer thickness with no other hallmarks of congenital glaucoma.