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 nun, 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.