Normative Pediatric Macular and RNFL Thickness Data Established With OCT 

Normative pediatric macular data indicated that age, gender, birth weight, and axial length can affect macular and RNFL thickness.

Normative pediatric macular and retinal nerve fiber layer (RNFL) thicknesses have been determined using optical coherence tomography (OCT), according to research published in Ophthalmic and Physiological Optics. Age, sex, and axial length must be considered when determining whether measurements obtained should be classified as normal, the report suggests. 

Researchers included 695 pediatric patients (mean age, 12.91 years; 50.79% girls) in the cross-sectional investigation and performed axial length, spherical equivalent, and OCT assessment. Study participants or their caretakers also completed questionnaires pertaining to their time spent outdoors and using media. The study’s objective was to determine normative pediatric macular thickness, macular volume, and RNFL values and examine potential influencing factors. 

Overall, axial length was 23.20 mm, and normative pediatric macular values included macular thickness, RNFL thickness, and macular volume values of 320.53 µm, 102.88 µm, and 8.88 mm3, respectively. Average macular thickness was significantly associated with both age (β, 0.77; P <.001) and axial length (β, -4.06; P <.001). 

Age, gender, birth weight and [axial length] need to be considered when evaluating quantitative macular thickness measurements using OCT.

No significant associations were noted between normative pediatric RNFL thickness and age, but RNFL thickness did correlate with axial length (β, -2.15; P =.002), birth weight (β, 0.003; P =.02) and a gender-specific effect of the body mass index (BMI) standard deviation score for boys (β, 1.93; P =.02), according to the report.

Stratified according to sector, RNFL thickness was affected by birth weight (β, 0.00; P =.001) and axial length (β, -3.92; P =.002) in the nasal region, by BMI (β, 4.07; P =.02) in the temporal inferior region, by axial length (β, -4.39; P =.007) in the nasal superior region, and by axial length (β, -6.25; P <.001) in the nasal inferior region.

“Age, gender, birth weight and [axial length] need to be considered when evaluating quantitative macular thickness measurements using OCT,” according to the study authors. “The normative data we obtained must be applied in a clinical evaluation of pediatric OCT scans, especially to classify them as normal.”

Study limitations include the use of only 1 type of OCT device to determine normative pediatric macular measurements and the use of non cycloplegic refraction to determine spherical equivalent. 
Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Söhnel T, Meigen C, Hiemisch A, et al. Normative data for macular and retinal nerve fibre layer thickness in healthy German children and adolescents using optical coherence tomography. Ophthalmic Physiol Opt. Published online March 17, 2023. doi:10.1111/opo.13123