The Role of the Retinal Nerve Fiber Layer Thickness on OCT in the Evaluation of Papillitis in Childhood Uveitis

& BULL; PURPOSE: To investigate the diagnostic value of using retinal nerve fiber layer thickness measured on optical co-herence tomography (OCT-RNFL) to diagnose papillitis in pediatric uveitis. & BULL; DESIGN: Retrospective cohort study. & BULL; METHODS: Demographic and clinical data were col-lected retrospectively for 257 children with uveitis (with 455 affected eyes). Receiver operating characteristic (ROC) analysis was performed to compare fluorescein angiography (FA, the diagnostic gold standard for papilli-tis) to OCT-RNFL in a subgroup of 93 patients. An ideal cut-off value for OCT-RNFL was then determined by cal-culating the highest Youden index. Finally, a multivariate analysis was applied to the clinical ophthalmological data. & BULL; RESULTS: Based on a subset of 93 patients who under-went both OCT-RNFL and FA, the ideal cut-off OCT-RNFL for diagnosing papillitis was > 130 & mu;m, with 79% sensitivity and 85% specificity. Among the entire co-hort, the prevalence of OCT-RNFL > 130 & mu;m was 19% (27/141), 72% (26/36), and 45% (36/80) in patients with anterior uveitis, intermediate uveitis, and panu-veitis, respectively. Our multivariate analysis of the clin-ical data revealed that OCT-RNFL > 130 & mu;m was associ-ated with a higher prevalence of cystoid macular edema, active uveitis, and optic disc swelling on fundoscopy, with odds ratios of 5.3, 4.3, and 13.7, respectively (all P < .001). & BULL; CONCLUSIONS: OCT-RNFL can be a useful non-invasive additional imaging tool for diagnosing papilli-tis in pediatric uveitis with relatively high sensitivity and specificity. OCT-RNFL was > 130 & mu;m in approx-imately one-third of all children with uveitis and was particularly prevalent in cases of intermediate uveitis and panuveitis. (Am J Ophthalmol 2023;254: 62-68. & COPY; 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ ))