Shaping OCT Norms in Children: The Impact of Age, Refraction, Gender, and Ethnicity

Purpose: To establish a normative database of optical coherence tomography (OCT) parameters in children and examine the effects of spherical refraction, age, gender, and ethnicity on these measurements. Methods: OCT measurements were performed using spectral-domain OCT (HD-OCT Cirrus 6000) on children aged 3 to 17.9 years. A total of 274 eyes from 137 children were included. Mean age was 10.41 ± 3.79 years and mean spherical equivalent refraction was +0.23 ± 2.79 diopters. Optic nerve and macular parameters were assessed, and a normative database was established distinguishing between children younger and older than 10 years. Only participants without any ophthalmological pathology with an OCT scan quality signal of 7 or above were included. Results: The study provides a normative database for optic nerve head parameters, retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and macular thicknesses in a normal pediatric population. Age showed a significant negative correlation with rim area and the temporal quadrant of RNFL thickness and a positive correlation with central macular thickness. Refraction demonstrated a significant positive correlation with rim area, RNFL, GCL, and macular thicknesses. Ethnicity was correlated with disk area, cup-to-disk ratios, cup volume, and RNFL thickness, and central macular thickness was significantly thicker in boys. Conclusions: This study provides reference normative data for Cirrus OCT measurements in normal children. These were significantly influenced by age, refraction, gender, and ethnicity. The tendency of diminution in spherical equivalent with age likely led to a thinning of RNFL, GCL, and macular thicknesses, whereas reorganization of the foveal zone during childhood possibly explained the increase in central macular thickness with age.