Interocular Symmetry in Macular Choroidal Thickness in Children

Objective. To report interocular differences in choroidal thickness in children using spectral domain optical coherence tomography (SD-OCT) and correlate findings with biometric data. Methods. This observational cross-sectional study included 91 (182 eyes) healthy children aged 6 to 17 years with no ocular abnormality except refractive error. After a comprehensive eye exam and axial length measurement, high definition macular scans were performed using SD-OCT. Two observers manually measured the choroidal thickness at the foveal center and at 1500 µm nasally, temporally, inferiorly, and superiorly. Interocular differences were computed; correlations with age, gender, refractive error, and axial length were performed. Results. Mean age was 10.40 ± 3.17 years; mean axial length and refractive error values were similar between fellow eyes. There was excellent correlation between the two observers’ measurements. No significant interocular differences were observed at any location. There was only a trend for right eyes to have higher values in all thicknesses, except the superior thickness. Most of the choroidal thickness measurements correlated positively with spherical equivalent but not with axial length, age, or gender. Conclusion. Choroidal thickness measurements in children as performed using SD-OCT revealed a high level of interobserver agreement and consistent interocular symmetry. Values correlated positively with spherical equivalent refraction

The Terrible Threes (PowerPoint)

Third nerve palsyA 3-year old female with a third cranial nerve palsy. One year prior to presentation, vomiting, headache noted along with left ptosis and anisocoria: Dx Horner Syndrome.20/20 OD, 20/25 OS; XT in primary gaze; Right HT on upgaze, left HT on downgazeMRIOvoid lesion attached to medial aspect of CN III composed of fibrocollagenous tissue lined with a layer of cuboidal and columnar epithelium.SurgeryAttache

The Terrible Threes

Third nerve palsyA 3-year old female with a third cranial nerve palsy. One year prior to presentation, vomiting, headache noted along with left ptosis and anisocoria: Dx Horner Syndrome.VA: 20/20 OD, 20/25 OS; XT in primary gaze; Right HT on upgaze, left HT on downgazeMRIOvoid lesion attached to medial aspect of CN III composed of fibrocollagenous tissue lined with a layer of cuboidal and columnar epithelium.SurgeryAttache

Macular Homonymous Hemianopsia

Patients with an optic tract lesion develop a homonymous hemianopsia associated with bow tie optic atrophy. Optical Coherence Tomography(OCT) has been proven to be a useful clinical tool in the diagnosis and follow-up of optic neuropathies and optic atrophy

Evaluation of Child with Full Optic Disc - Role of Imaging; in Distinguishing Pseudopapilledema versus Real; Papilledema (OCT is Useful)

Distinguishing low grade papilledema (Frisen grade<2, no vessel obscuration) from pseudopapilledema can be challenging in children, especially the younger ones. Multiple imaging modalities have been used over the past few decades, and most recently, OCT has become a popular method due to the ease of obtaining it in the younger population

Doc, I Really Can't See!

Obstructive hydrocephalus associated with dilated third ventricle can result in central scotoma and optic atrophy without papilledema or afferent pupillary defect early on

Fibrous Dysplasia

Presentation covering an overview of fibrous dysplasia

Hue: A Quantitative Measure of Optic Nerve Color

Optic nerve color is one of the three cardinal features used to evaluate the optic nerve. Quantitative measures have been used to aid in evaluating each feature; however, most methods for evaluating optic nerve color require specialized non-commercially available equipment (microdensitometry and fundus reflectometry). Hue is a quantitative measurement of color that has been separated from an image's intensity and can be easily obtained from routine fundus photography without significant image manipulation. We hypothesize that hue can be easily used to differentiate between glaucomatous optic neuropathy (GOA) versus non-glaucomatous optic neuropathy (NGOA)