Peripapillary retinal nerve fiber layer layer and minimum rim width in myopic children under age 18

PERİPAPİLLARY RETİNAL NERVE FİBER LAYER LAYER AND MİNİMUM RİM WİDTH İN MYOPİC CHİLDREN UNDER AGE 18 Purpose: To determine the normal values of BMO-MRW(Bruch membrane opening-minimum rim width) and RNFL(retinal nerve fiber layer) with SD-OCT new rim analysis(Glaucoma Premium Module Edition[GPME]) in healthy myopic Turkish children under age 18 and to show the advantages over standard drawn RNFL(without anatomic positioning system[APS] ) Methods : This study included 758 eyes of 379 healthy children aged between 4 and 17.Myopic eyes were grouped according to spherical refractive errors as above -4 diopter G1(100 eyes) ; between -4 and -1 diopter G2(524 eyes) ; below -1 diopter G3(134 eyes).All participants underwent comprehensive ophthalmic examination cycloplegic refraction and axial length measurements.After that all participants were examined with Heidelberg Spectralis SD-OCT,including Glaucoma Premium Module Edition software and confocal laser scanning ophthalmoscopy (HRT3).With GPME , we analyzed the neuroretinal rim(Bruch Memrane Opening -minimum rim width[BMO-MRW]) and RNFL with anatomic positioning system(APS) Results : A total of 758 eyes of 379 children (303 girls, 76 boys) with a mean age of 14.67 ± 3.44 were included in the study. The spherical mean of the eyes in G1 -5,67 ± 2,22 ; in G2 -1,78 ± 0,77;in G3 +0,21 ± 0,48 were found. Global RNFL without APS mean averages were 86.6 ± 12.1 micrometers in G1, 94.3 ± 12.8 micrometers in G2 , 96.3 ± 15.9 micrometers in G3 (G1 vs G2 p <0.001 ,G1 vs G3 p <0.001 G2 vs G3 p=0,048). Global RNFL with APS averages were 102.9 ± 10.8 micrometers in G1, 103.9 ± 10.6 micrometers in G2, and 105.4 ± 11.3 micrometers in G3 (G1vs G2 vs G3 p=0,567) .Global BMO-MRW averages were 355 ± 77.5 micrometers in G1, 374,1 ± 63.6 micrometers in G2, and 380.9 ± 63.6 in G3 (G1 vs G3 p = 0,01 G1 vs G3 p=0,006).BMO area averages were 2,12 ± 0,45 mm2 in G1, 2,03 ± 0,39 in G2 , 2,10 mm2 ± 0,51(G1 vs G2 p = 0.012) In the HRT measurements, disk size was 1.99 ± 0.52 mm2 in G1, 1.80 ± 0.44 mm2 in G2, and 1.79 ± 0.38 mm2 G3 (G1 vs G2 p = 0.003 ;G1 vs G3 p = 0.011). There were no significant difference between BMO-MRW, RNFL with APS, standardized RNFL without APS and HRT3 in terms of false positivity that we accepted the number of sectors classified as pathologic per subject x Conclusions: In this study normal values were determined for RNFL with APS , RNFL without APS and BMO-MRW measurements in healthy sub-18-year-old myopic children.Because of thinning is not seen the eyes above -4 diopters and between -4 and -1 diopter myopic eyes by RNFL with APS according to RNFL without APS , we thought this technique can give more correct results. Likewise, BMO-MRW doesn't change in moderate myopia between -4 and -1 diopters so in this topics we can think that BMO-MRW is new useful parameter. Increasing the number of cases with similar studies can contribute to the creation of a normative database for myopia.