Associations between Orbital Morphology and Exophthalmos Changes after Endoscopic Orbital Decompression to Treat Thyroid-related Orbitopathy

Purpose@#To investigate orbital morphology parameters associated with exophthalmos changes in patients undergoing endoscopic orbital decompression to treat thyroid-related orbitopathy. @*Methods@#In total, 33 eyes of 18 patients with thyroid-related orbitopathy who underwent endoscopic orbital decompression were included in this retrospective study. Data were collected before and 6 months after surgery. We performed Hertel exophthalmometry and derived orbital morphology parameters from two-dimensional facial computed tomography records. Parameters associated with exophthalmos reduction on univariate linear regression analysis were subjected to multivariate linear regression analyses. @*Results@#Univariate linear regression showed that the preoperative length of the medial orbital wall (β = 0.179, p = 0.032) and the postoperative distance from the cone apex to the medial wall defect (β = -0.139, p = 0.006) were associated with exophthalmos reduction after endoscopic orbital decompression surgery. Multivariate linear regression of these two parameters showed that the distance from the apex to the medial wall defect was associated with exophthalmos reduction (β = -0.118, p = 0.019). @*Conclusions@#The postoperative distance from the cone apex to the medial wall defect was associated with exophthalmos reduction. In patients with thyroid-related orbitopathy, this association should be considered when planning endoscopic orbital decompression.

Iatrogenic Horner’s Syndrome Developing after Robot-assisted Transaxillary Total Thyroidectomy

Purpose@#We report a case of iatrogenic Horner’s syndrome developing after robot-assisted transaxillary total thyroidectomy.Case summary: A 31-year-old female with right-eye ptosis was referred to our clinic. Three weeks prior, she had undergone robot-assisted total thyroidectomy via the right transaxillary approach to treat right-side thyroid cancer. On ocular examination, the palpebral fissure widths were 5.0 mm in the right lid and 8.0 mm in the left lid, the marginal reflex distances 1, 1.0 mm in the right lid and 4.0 mm in the left lid, and the levator muscle function of both eyes normal. In a dark room, the pupil diameter was 2.5 mm in the right eye and 4.0 mm in the left eye. She did not complain of facial anhidrosis. Thirty minutes after instillation of 0.5% (w/v) apraclonidine into the right eye, the right palpebral fissure width increased from 5.0 to 8.0 mm, and the pupil size from 2.5 to 4.0 mm in the dark. @*Conclusions@#Horner’s syndrome can develop after robot-assisted transaxillary total thyroidectomy; patients should be counselled in this regard.

Changes in Eyelid Parameters after Orbital Decompression according to the Surgical Approach in Thyroid Eye Disease

Purpose@#To evaluate the changes in eyelid parameters after the endonasal approach compared with transcaruncular medial wall decompression combined with the transconjunctival inferior wall decompression approach with inferomedial strut preservation. @*Methods@#In total, 71 patients with thyroid eye disease who underwent orbital decompression were retrospectively evaluated. The data collected included Hertel exophthalmometry, marginal reflex distance 1, marginal reflex distance 2, interpalpebral fissure, levator function test measures, and complications related to surgery. @*Results@#Proptosis reduction produced a statistically significant improvement across all decompression groups. Lower eyelid retraction produced a statistically significant improvement in the two-wall decompression groups but not in the one-wall decompression groups. No statistical difference was observed in the upper eyelid retraction and levator function after surgery across all decompression groups. In the post-hoc analysis, statistical improvement was not observed in the lower eyelid retraction between the endonasal and transcaruncular approach in the one-wall and two-wall decompression groups, although statistically significant exophthalmos reduction and improvement in the lower eyelid retraction was noted in the two-wall decompression subgroups compared with one-wall decompression subgroups. @*Conclusions@#Our study showed no differences in eyelid parameters between the endonasal and transcaruncular decompression approaches in one-wall and two-wall decompression. In the two-wall decompression group, proptosis reduction was greater with the endonasal approach than with the transcaruncular approach when the strut was preserved; however, it does not lead to a significant difference in the improvement of lower eyelid retraction.

Factors Associated with Postoperative Strabismus by Endoscopic Orbital Decompression in Patients with Thyroid-associated Ophthalmopathy

Purpose@#To identify the factors associated with postoperative strabismus by endoscopic orbital decompression in patients with thyroid-associated ophthalmopathy (TAO). @*Methods@#This study was a retrospective chart review conducted using the data from 35 patients with TAO (13 with postoperative strabismus and 22 with postoperative non-strabismus) who underwent endoscopic orbital decompression. Hertel exophthalmometry, prism strabismus test, and thyroid-related autoantibody test were performed, and extraocular muscle (EOM) area was calculated using orbital computed tomography. @*Results@#Univariate logistic regression analysis showed that all EOM areas were significantly different between the postoperative strabismus group and non-strabismus group (p < 0.05). Multivariate logistic regression analysis including borderline significant (p < 0.1) variables (age and sex) showed that male sex (β = -3.346, p = 0.031) and left lateral rectus area (β = 0.181, p = 0.046) were associated with postoperative strabismus. In the postoperative strabismus group, there were nine patients with horizontal strabismus and four patients with complex strabismus. In the horizontal strabismus group, the angle of strabismus was positively correlated with the left medial rectus (LMR) area (r = 0.749, p = 0.020). In the complex strabismus group, the vertical angle of strabismus was positively correlated with the left inferior rectus (LIR) area (r = 0.949, p = 0.048). @*Conclusions@#Sex and lateral rectus muscle area were associated with postoperative strabismus by endoscopic orbital decompression in patients with TAO. The areas of LMR and LIR, in particular, were positively correlated with horizontal and vertical angles, respectively. These results could be considered predictive of strabismus after endoscopic orbital decompression.

Empty Sella Syndrome Associated with Growth Hormone Deficiency:the First Case Report of WeissKruszka Syndrome

Weiss-Kruszka syndrome (WSKA), caused by heterozygous loss-of-function variants in ZNF462 gene, is a recently described and extremely rare genetic disorder. The main phenotypes include characteristic craniofacial features, ptosis, dysgenesis of the corpus callosum, and neurodevelopmental impairment. We report the first Korean boy with molecularly confirmed WSKA presenting with an atypical manifestation. A 16-year-old boy with a history of bilateral ptosis surgery presented with short stature (−3.49 standard deviation score) and delayed puberty. The patient showed characteristic craniofacial features including an inverted triangular-shaped head, exaggerated Cupid's bow, arched eyebrows, down-slanting palpebral fissures, and poorly expressive face. He had a mild degree of intellectual disability and mild hypotonia. Endocrine studies in the patient demonstrated complete growth hormone deficiency (GHD) associated with empty sella syndrome (ESS), based on a magnetic resonance imaging study for the brain that showed a flattened pituitary gland and cerebrospinal fluid space herniated into the sella turcica. To identify the genetic cause, we performed whole exome sequencing (WES). Through WES, a novel de novo heterozygous nonsense variant, c.4185del; p.(Met1396Ter) in ZNF462 was identified. This is the first case of WSKA accompanied by primary ESS associated with GHD. More clinical and functional studies are needed to elucidate this association.

Factors Associated with Postoperative Strabismus by Endoscopic Orbital Decompression in Patients with Thyroid-associated Ophthalmopathy

Purpose@#To identify the factors associated with postoperative strabismus by endoscopic orbital decompression in patients with thyroid-associated ophthalmopathy (TAO). @*Methods@#This study was a retrospective chart review conducted using the data from 35 patients with TAO (13 with postoperative strabismus and 22 with postoperative non-strabismus) who underwent endoscopic orbital decompression. Hertel exophthalmometry, prism strabismus test, and thyroid-related autoantibody test were performed, and extraocular muscle (EOM) area was calculated using orbital computed tomography. @*Results@#Univariate logistic regression analysis showed that all EOM areas were significantly different between the postoperative strabismus group and non-strabismus group (p < 0.05). Multivariate logistic regression analysis including borderline significant (p < 0.1) variables (age and sex) showed that male sex (β = -3.346, p = 0.031) and left lateral rectus area (β = 0.181, p = 0.046) were associated with postoperative strabismus. In the postoperative strabismus group, there were nine patients with horizontal strabismus and four patients with complex strabismus. In the horizontal strabismus group, the angle of strabismus was positively correlated with the left medial rectus (LMR) area (r = 0.749, p = 0.020). In the complex strabismus group, the vertical angle of strabismus was positively correlated with the left inferior rectus (LIR) area (r = 0.949, p = 0.048). @*Conclusions@#Sex and lateral rectus muscle area were associated with postoperative strabismus by endoscopic orbital decompression in patients with TAO. The areas of LMR and LIR, in particular, were positively correlated with horizontal and vertical angles, respectively. These results could be considered predictive of strabismus after endoscopic orbital decompression.

Empty Sella Syndrome Associated with Growth Hormone Deficiency:the First Case Report of WeissKruszka Syndrome

Weiss-Kruszka syndrome (WSKA), caused by heterozygous loss-of-function variants in ZNF462 gene, is a recently described and extremely rare genetic disorder. The main phenotypes include characteristic craniofacial features, ptosis, dysgenesis of the corpus callosum, and neurodevelopmental impairment. We report the first Korean boy with molecularly confirmed WSKA presenting with an atypical manifestation. A 16-year-old boy with a history of bilateral ptosis surgery presented with short stature (−3.49 standard deviation score) and delayed puberty. The patient showed characteristic craniofacial features including an inverted triangular-shaped head, exaggerated Cupid's bow, arched eyebrows, down-slanting palpebral fissures, and poorly expressive face. He had a mild degree of intellectual disability and mild hypotonia. Endocrine studies in the patient demonstrated complete growth hormone deficiency (GHD) associated with empty sella syndrome (ESS), based on a magnetic resonance imaging study for the brain that showed a flattened pituitary gland and cerebrospinal fluid space herniated into the sella turcica. To identify the genetic cause, we performed whole exome sequencing (WES). Through WES, a novel de novo heterozygous nonsense variant, c.4185del; p.(Met1396Ter) in ZNF462 was identified. This is the first case of WSKA accompanied by primary ESS associated with GHD. More clinical and functional studies are needed to elucidate this association.

Associations between the Munk Score and Tear Film Scan Revealed byCorneal Topography after Dacryocystorhinostomy

Purpose@#We evaluated changes in the tear film parameters of the corneal surface, and their correlations with Munk scores,based on corneal topographic scans of patients with nasolacrimal duct obstructions who underwent dacryocystorhinostomy(DCR). We explored whether tear parameters can serve as useful indicators of functional surgical success. @*Methods@#We assessed 72 eyes of 45 patients diagnosed with nasolacrimal duct obstruction who underwent DCR. Tear film parameterswere measured via corneal topography (Keratograph® 5M) once before, and three times after surgery, and includedtear meniscus height (TMH), and the initial and average keratographic tear break-up time (NIKBUT-first and NIKBUT-average,respectively; measured noninvasively). @*Results@#The three postoperative TMH values were 0.31 ± 0.20, 0.30 ± 0.22, and 0.29 ± 0.15 mm, all of which were significantlylower than the preoperative value of 0.48 ± 0.29 mm (all, p 0.999).Changes in the Munk score after surgery correlated significantly with changes in the TMH (r = 0.46, p < 0.001). When functionalsuccess was defined as a Munk score ≤ 1, the area under the curve (AUC) value corresponding to the ability of TMH to definefunctional success of 0.995, was statistically significant (cut-off of 0.31 mm; p < 0.001). @*Conclusions@#The TMH DCR correlated significantly with the Munk score, which is a quantitative measure of clinical symptomseverity. The ability of TMH to define functional surgical success was excellent.

Lacrimal Sac Metastasis from Phyllodes Tumor of the Breast

No abstract available.

Factors Affecting Persistent Diplopia after Surgical Repair of Isolated Inferior Orbital Wall Fracture

PURPOSE: To investigate factors affecting persistent diplopia after surgical repair of isolated inferior orbital wall fractures. METHODS: Thirty-three patients who underwent surgical repair of isolated inferior orbital wall fractures in Inha University Hospital Ophthalmology Department from 2014 to 2017 were enrolled in this study. The authors examined facial computed tomography, diplopia, extraocular muscle movement, and Hertel's exophthalmometer before and 6 months after surgery. The diplopia which was not recovered even at 6 months postoperatively was defined as persistent diplopia. Multivariable logistic regression analyses were performed on parameters that were found to be related to persistent diplopia using univariable logistic regression analyses. RESULTS: Univariable regression analysis showed that preoperative ocular motility limitation, preoperative diplopia, the type of fracture, the number of contacts with the fracture site and extraocular muscle (EOM), and EOM tenting were associated with persistent postoperative diplopia. Multivariable regression analysis using the previously mentioned five parameters showed 28.3-fold and 17.4-fold greater probabilities of diplopia after surgery in preoperative diplopia and EOM tenting, respectively (p = 0.023). CONCLUSIONS: Preoperative diplopia and EOM tenting were associated with persistent postoperative diplopia. These parameters were predictors of persistent diplopia in eyes with isolated inferior orbital wall fractures.

Endoscopic and Transconjunctival versus Transcaruncular and Transconjunctival Reconstruction of Medial and Inferior Orbital Wall Fractures

PURPOSE: To compare two combined surgical techniques, endoscopic endonasal surgery with transconjunctival reconstruction and transcaruncular surgery with transconjunctival reconstruction, when used to treat both medial and inferior orbital wall fractures. METHODS: A retrospective review of 63 patients who were followed up from January 2011 to December 2014 at Inha University Hospital for surgical reconstruction of combined medial and inferior orbital wall fractures was undertaken. We compared between the patients the computed tomographic scans, diplopia, extraocular muscle (EOM) movements, and Hertel's exophthalmometer exams pre- and post-6 months surgery. A total of 29 patients received endoscopic transnasal surgery with trasconjunctival reconstruction, and 34 received transcaruncular surgery with trans-conjunctival reconstruction. RESULTS: There were no significant differences between the two combined methods in terms of the primary and peripheral gaze diplopia or the restriction of EOM movement 6 months after surgery. However, statistically significant differences were observed in exophthalmometer measurements 6 months after surgery. CONCLUSIONS: The two combined surgical methods showed similar results in terms of postoperative primary and peripheral gaze diplopia, EOM restriction, and enophthalmos. With respect to postoperative peripheral diplopia, endoscopic endosnasal surgery with transconjunctival reconstruction showed several advantages over the other method considered in this study. An appropriate surgical method should be selected by comparing the relative advantages and disadvantages.

Prognostic Factors Associated with Surgical Time of Endonasal Dacryocystorhinostomy

PURPOSE: To determine the prognostic factors associated with surgical time of endonasal dacryocystorhinostomy (DCR). METHODS: From April 2009 to June 2014, 66 eyes of 66 patients who underwent endonasal DCR for 5-year periods were retrospectively evaluated with regard to surgical time and several other factors. The factors were patient factors (age, sex), category of diagnosis (inflammation and non-inflammation), and systemic factors (diabetes mellitus [DM], hypertension [HTN], anticoagulant agents, sinusitis history). We divided the study period into three subperiods and compared their surgical time. The anatomical factor of thickness of the maxillary frontal process was evaluated by computed tomography (CT), as was the existence of symptom recurrence after surgery and reoperation according to surgical time. A total of 66 cases (right: 31, left: 35) were included. Any case with concurrent surgery, abnormal structure of the nasal cavity, or bilateral DCR was excluded. RESULTS: Average surgical time was 49.95 minutes. Surgical time of endonasal DCR was short in inflammatory cases (p = 0.047), in the third surgical period (p = 0.001), and was correlated with thickness of the maxillary frontal process (p = 0.001). In addition, surgical time correlated with the existence of symptom recurrence after surgery and reoperation (p = 0.012). CONCLUSIONS: It is considered that surgeon skill affects surgical time, and the thickness of the maxillary frontal process by CT will aid in the prediction of surgical time and success rate of endonasal DCR.

Primary Systemic Amyloidosis Involving the Lacrimal Sac

No abstract available.

Endoscopic Transnasal versus Transcaruncular Reconstruction in Isolated Medial Orbital Wall Fractures

PURPOSE: To compare 2 surgical techniques, endoscopic transnasal reconstruction and transcaruncular reconstruction in isolated medial orbital wall fractures. METHODS: This study included 79 isolated medial orbital wall fracture patients from January 2011 to December 2012 of Department of Ophthalmology, Inha University Hospital. The authors compared computed tomographic scans, diplopia, extraocular muscle (EOM) movements, and Hertel's exophthalmometer exams pre- and post-surgery. Thirty-five patients received endoscopic transnasal reconstruction and 44 received transcaruncular reconstruction. RESULTS: The 2 surgical methods showed no significant differences in primary gaze diplopia (p = 0.50), restriction of EOM movements (p = 0.48), remaining enophthalmos of more than 2 mm (p = 0.99), and improvement in enophthalmos (p = 0.07) when compared 6 months after surgery. Statistically significant differences were observed in peripheral diplopia (p = 0.04) 6 months after surgery. CONCLUSIONS: The 2 surgical methods present similar effectiveness in postoperative primary gaze diplopia, EOM restriction, and enophthalmos. With respect to postoperative peripheral diplopia, endoscopic transnasal reconstruction method showed advantages. The surgical method should be selected by comparing advantages and disadvantages.

Uncommon Ocular Manifestations of Neurofibromatosis: Case Report and Review

PURPOSE: To report and review several cases of uncommon ocular manifestations in neurofibromatosis patients. CASE SUMMARY: A 19-year-old woman diagnosed with type 2 neurofibromatosis visited our hospital with amblyopia of the right eye and mild visual disturbance of the left eye. Best corrected visual acuity was 20/250 in the right eye, 20/25 in the left eye and relative afferent pupillary defect in the right eye was observed. Fundus examination of both eyes showed papilledema. Magnetic resonance imaging showed schwannoma from the optic nerve to the optic chiasm. A 28-year-old woman diagnosed with type 2 neurofibromatosis visited our hospital with amblyopia of the right eye. Best corrected visual acuity was finger count in the right eye, 20/20 in the left eye and relative afferent pupillary defect in the right eye was observed. Fundus examination of the right eye showed a slightly elevated lesion at the macula, as well as dragged optic disc and retinal vessels to the macula. An 8-year-old girl diagnosed with type 1 neurofibromatosis visited our hospital with enophthalmos and strabismus of the left eye. On exophthalmometry, enophthalmos in the left eye was found; measurements were 15.0 mm in the right eye and 13.0 mm in the left eye. Three-dimensional computed tomography revealed sphenoidal hypoplasia and a left lateral orbital wall defect. CONCLUSIONS: The authors of the present study report on neurofibromatosis patients who had an uncommon ocular manifestation. Neurofibromatosis can represent various ocular manifestations but reports of compressive optic neuropathy, dragged disc syndrome and sphenoidal hypoplasia are rare.

The Antifibrotic Effects of alpha-Tocotrienols in Primary Cultured Orbital Fibroblasts from Thyroid-Associated Ophthalmopathy Patients

PURPOSE: To evaluate the antiproliferative and antifibrotic effects of alpha-tocotrienols in primary cultured orbital fibroblasts from thyroid-associated ophthalmopathy (TAO) patients. METHODS: Orbital fibroblasts were cultured (5 eyes from TAO patients, 5 eyes from normal patients) and classified into a control group, alpha-tocotrienol group and alpha-tocopherol group. The cell viability was measured using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The proliferation of orbital fibroblasts was measured using the Click-iT(TM) assay. The collagen production of the control and alpha-tocotrienol groups was measured using a hydroxyproline assay. RESULTS: The alpha-tocotrienol and alpha-tocopherol groups showed no cytotoxicity up to 150 microm in orbital fibroblasts from TAO and normal patients. The proliferation of orbital fibroblasts from TAO and normal patients was significantly inhibited with alpha-tocotrienol at 80 microm and 120 microm. The collagen production of orbital fibroblasts from TAO patients was significantly inhibited with alpha-tocotrienol at 120 microm. CONCLUSIONS: The results from the present study indicate that non-toxic concentrations of alpha-tocotrienol have significant antiproliferative and antifibrotic effects on orbital fibroblasts from TAO patients.

A Case of Atypical Miller-Fisher Syndrome with Internal Carotid Artery Stenosis / 대한소아신경학회지

Miller-Fisher syndrome is an acute poly-neuropathy typically characterized by the triad of ophthalmoplegia, ataxia, and areflexia. Other poly-neuropathy diseases include Guillain-Barre syndrome and Bickerstaff brainstem encephalitis. However, not all cases of Miller-Fisher syndrome have the typical three symptoms. These diseases have been differentiated by clinical manifestations and anti-GQ1b IgG antibody testing. In Miller-Fisher syndrome, anti-GQ1b IgG antibody is present in over 95% of patients; however, the frequency is not so high in normal subjects or in those with other poly-neuropathy diseases. Infectious illnesses, such as respiratory diseases and gastrointestinal diseases, usually precede Miller-Fisher syndrome. In general, Miller-Fisher syndrome is a self-limiting illness; however, a few cases of Miller-Fisher syndrome progressing to respiratory failure have been reported, particularly in children. In this case, we report abnormal angiographic findings. We report a case of atypical Miller-Fisher syndrome with internal carotid artery stenosis treated with prednisolone.

Intravitreal Triamcinolone Acetonide Injection at the Time of Pars Plana Vitrectomy for Retained Lens Material

PURPOSE: To report the experiences at our institute of pars plana vitrectomy (PPV) in combination with intravitreal triamcinolone acetonide (IVTA) injection in patients with retained lens material after cataract surgery. METHODS: The medical records of patients who underwent PPV between January 2005 and December 2006 after complicated cataract surgery in which lens material was dropped into the vitreous cavity were reviewed retrospectively. RESULTS: Five eyes of five patients were treated by vitrectomy and removal of the dislocated lens material and were administered an adjuvant intravitreal injection of 4 mg triamcinolone acetonide at the end of surgery. IVTA administration induced a rapid improvement in vision within six weeks postoperatively. Final visual acuity was 20/32 or better in all patients. Inflammatory cystoid macular edema (CME) that existed preoperatively was promptly improved after IVTA. Intraocular pressure increased transiently in one patient. No procedure-related complications were observed. CONCLUSIONS: PPV with additional IVTA was successfully performed in five eyes with retained lens material and resulted in a marked resolution of vitreous inflammation, an improvement in CME and rapid visual recovery. The authors recommend that IVTA administration should be investigated more thoroughly as an adjunct during the management of retained lens material.

A Case of Parinaud Syndrome After Intracranial Hemorrhage

PURPOSE: To report one case of Parinaud syndrome after intracranial hemorrhage. CASE SUMMARY: A 45-year-old man visited our emergency department complaining of right-sided weakness and right-sided hypoesthesia. Intracranial hemorrhage in the left thalamus and intraventricular hemorrhage were noted upon brain computed tomography, and the patient was admitted to the department of neurosurgery. He complained of diplopia and upgaze palsy, and he was referred to the department of ophthalmology. The patient exhibited convergence-retraction nystagmus, light-near dissociation and vertical gaze limitation within 15 degrees. The best-corrected visual acuity of both eyes was 20/20, but convergence-retraction nystagmus and light-near dissociation still remained. Upgaze palsy was also not improved. CONCLUSIONS: Once symptoms manifest, Parinaud syndrome does not resolve except in patients with hydrocephalus. If the findings persist for more than 6 months, the likelihood of complete resolution is very small. We reported a case of typical Parinaud syndrome with upgaze palsy, convergence-retraction nystagmus and light-near dissociation after thalamic and intraventricular hemorrhage.

Comparison of RNFL Thickness among Normal, Glaucoma Suspect and Glaucoma in Children

PURPOSE: To compare the retinal nerve fiber layer (RNFL) thickness among normal children, glaucoma suspects, and children with glaucoma, using optical coherence tomography (OCT). METHODS: Ninety-four eyes of 47 normal children, 62 eyes of 38 glaucoma suspects and 33 eyes of 21 children with glaucoma, from the ages of 5 to 15 years were examined at the Ophthalmology Center at the Inha University Hospital. The RNFL thickness was measured with OCT. Patient cooperation and signal strength of the OCT scans were assessed. The mean, superior, inferior, nasal, and temporal RNFL thicknesses were measured by OCT in all three groups. RESULTS: After adjustment by refractive error, the RNFL thicknesses of the mean, superior, inferior, nasal, and temporal areas were 110.8+/-10.1 micrometer, 140.1+/-17.5 micrometer, 134.1+/-14.8 micrometer, 79.9+/-14.5 micrometer, and 89.2+/-16.8 micrometer, respectively, in the normal group; 107.9+/-10.8 micrometer, 134.8+/-15.5 micrometer, 130.2+/-18.8 micrometer, 75.4+/-17.1 micrometer, and 91.2+/-18.7 micrometer, respectively, in the glaucoma suspect group; and 102.8+/-18.1 micrometer, 129.5+/-16.5 micrometer, 126.1+/-20.2 micrometer, 70.3+/-19.7 micrometer, and 85.1+/-16.9 micrometer, respectively, in the glaucoma patient group. There was a significant difference among the three groups in all locations except in the temporal area (p=0.003). CONCLUSIONS: RNFL thickness in children measured by OCT may be useful in the diagnosis and follow-up of glaucoma in children.