Analysis of optical coherent tomography (OCT) imaging findings and outcomes in the paediatric population over 5 years at Ipswich Hospital NHS Trust, UK

Session Details

Session Title: Free Paper Session 17: Imaging II

Session Date/Time: Saturday 09/09/2017 | 08:00-09:30

Paper Time: 08:12

Venue: Room 120

First Author: : D.Mitkute UK

Co Author(s): :    C. Patel   D. James   V. Kostakis   G. Porter                    

Abstract Details

Purpose:

1. To evaluate the need for OCT imaging in children. 2. To evaluate a role of OCT imaging in children for assessing ocular pathology. 3. To evaluate the effectiveness of OCT imaging in differentiating optic nerve head drusen (ONHD) from optic disc edema (ODE). 4. To evaluate the appropriateness of Magnetic Resonance imaging (MRI) requests.

Setting:

Ophthalmology department, Ipswich Hospital NHS Trust, UK

Methods:

Retrospective study of electronic medical records of all children who had the OCT imaging in the Ophthalmology department from October 2010 to October 2015 and were no older than 16 years of age. Electronic patient notes, MRI reports, lumbar puncture report, ultrasound B- scan and OCT scan images were analysed. To differentiate ODE from ONHD on the OCT scan images we used the “lumpy-bumpy” internal contour of the optic nerve head in ONHD and the recumbent “lazy V” pattern of the sub-retinal hypo-reflective space in ODE (Johnson et al., ARCH Ophthalmol, Jan 2009).

Results:

151 children had the OCT imaging in our clinic over the study period of 5 years. Majority of them were girls (n=80, 53%) and the mean age was 10. The OCT imaging was requested for 119 (79%) children to evaluate optic nerve head while 32 (21%) had a scan of the macula and 22 (14.5%) both macula and optic nerve head were scanned. We were unable to perform the OCT imaging for 3 children (2%) due to poor cooperation. The most common diagnosis made among the children having their optic nerve head OCT imaging was ONHD (43%), followed by normal disc (32%), ODE (9%). 25 children in this subgroup had an ultrasound B-scan which confirmed ONHD in 24 children. MRI was requested in 36 children, which revealed an abnormality in only 3 of them. Lumbar puncture was done in 5 children.

Conclusions:

The OCT imaging is useful, non-invasive and quick imagining tool for assessing ocular pathology in children. Optic nerve head OCT imaging aids diagnosis in suspicious optic discs and avoids unnecessary imaging.

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