Absence of age-related optic disk changes in young children with optic nerve hypoplasia

Purpose To determine whether the ratio of optic disk diameter to disk-to-macula distance (DD/DM) in children with optic nerve hypoplasia (ONH) changes over time. Patients and methods Fifteen subjects (29 eyes) enrolled in a prospective registry study on ONH had fundus photography performed under the age of 24 months and again at 60 months. Using the ratio of the DD/DM method, the relative size of the optic disk was assessed twice for each photo by one masked expert examiner to determine whether any change in relative disk size occurred over time. Results There was no change in relative optic disk size between initial and final fundus photographs. The average (+/-SD) age at the time of initial and final fundus photography was, respectively, 11.6+/-5.2 months and 60.6+/-1.3 months. Strong concordance was noted between the average DD/DM of the initial and the final photographs (rho = 0.939; 95% CI: 0.893, 0.981). There was negligible difference between the individual time point measurements (-0.011+/-0.03) (95% LOA: -0.07, 0.04). Conclusion There were no clinically significant changes in relative optic disk size over time in children with ONH; thus, DD/DM measurements need not be adjusted by age beyond 1 year in children with this disorder.