Racial Variation in Optic Nerve Head Parameters Quantified in Healthy Newborns by Handheld Spectral Domain Optical Coherence Tomography

Purpose: To characterize optic nerve head (ONH) morphology and parameters, including vertical disk diameter, vertical cup diameter, and vertical cup/disk ratio in healthy, full-term newborns using a handheld spectral domain optical coherence tomography (SD-OCT) device.

Methods: In this prospective observational case series, healthy white, black, and Hispanic full-term newborns delivered at the Duke Birthing Center between August 2010 and May 2011 underwent dilated fundus examination and SD-OCT imaging of the optic nerve in each eye. OCT parameters were calculated and compared for each group of infants.

Results: A total of 58 consecutive newborns of white (n = 22), black (n = 15) and Hispanic (n = 21) ethnicity were included. Mean vertical disk diameter in white, black, and Hispanic newborns was 1.29 ± 0.15 mm (standard deviation), 1.38 ± 0.14 mm, and 1.38 ± 0.14 mm, respectively (white versus Hispanic, P = 0.02; white versus black, P = 0.07). Mean vertical cup diameter in white, black, and Hispanic newborns was 0.44 ± 0.15 mm, 0.56 ± 0.23 mm, and 0.46 ± 0.30 mm, respectively (white versus black, P = 0.03). Mean vertical cup/disk ratio was 0.34 ± 0.10 for white, 0.40 ± 0.17 for black, and 0.33 ± 0.20 for Hispanic newborns (P = 0.07 for white versus black).

Conclusions: Handheld SD-OCT is an effective means of imaging the ONH in newborns. Racial differences in cup/disk ratio are present at birth. These data may serve as the beginning of a normative dataset for characterizing development of the ONH as well as for comparison to the neonatal ONH in disease states.