Longitudinal study of optic cup progression in children

Abstract

Purpose: To determine the normative rate of cup-to-disc-ratio (C:D) progression in children and the effect of prematurity and low birth weight on this rate.

Method: In a single pediatric ophthalmology practice, a single examiner evaluated optic cup size by serial ophthalmoscopy over a minimum of 5 years in 92 patients (184 eyes) without intraocular surgery or optic nerve disease. A cross-sectional analysis of C:D was performed per year of age from 0 to 10 years and linear regression was used to compare C:D progression between preterm and term children and between low versus normal birth weight children.

Results: Children exhibited progressive optic cupping. In term children, mean C:D increased by 0.0075 per year. Rate of mean C:D progression was double in children born preterm: 0.0160 (P = .049, comparison to term) per age-year. A similar, nonsignificant trend is observed when comparing low birth weight to normal children (P = .131).

Conclusion: Prematurity and low birth weight are associated with increased rate of cupping in children. Clinicians should recognize that C:D progression is not a specific sign of glaucoma in children.