Advancements in Swept-Source OCT Enhance Early Detection of Childhood Glaucoma

Recent research highlights the potential of swept-source anterior segment optical coherence tomography (SS-ASOCT) as a noninvasive and effective tool for diagnosing early-onset childhood glaucoma. Published online by JAMA Ophthalmology on May 22, 2025, the study conducted by Sushmita Kaushik and colleagues from the Advanced Eye Centre at the Postgraduate Institute of Medical Education and Research in Chandigarh, India, investigates how SS-ASOCT can differentiate between children with and without glaucoma in early stages.

The study involved a prospective, comparative analysis of pediatric patients under 2 years old. Using the 'flying baby' technique, SS-ASOCT imaging focused on key structures such as the trabecular meshwork (TM), angle opening distance, and angle recess area. The team evaluated these parameters in 23 children without glaucoma and 30 with early-onset glaucoma, diagnosing classifications based on traditional ophthalmoscopic eye examination.

Findings revealed that the visibility of the TM shadow was significantly reduced in children with glaucoma, with only 26.7% showing clear visualization compared to 100% in children without glaucoma. The presence of a clearly visible TM structure was a strong indicator, with an area under the receiver operating characteristic curve reaching 0.87 for diagnosing non-glaucomatous eyes. Moreover, children with glaucoma showed increased anterior chamber angle measurements.

Remarkably, in children with corneal opacity but no glaucoma, SS-ASOCT successfully visualized the TM structure in all cases, enabling accurate diagnosis. These insights suggest that SS-ASOCT can serve as a valuable in-office biomarker, facilitating early detection and treatment of childhood glaucoma and potentially improving long-term eye health outcomes.

This research underscores the growing importance of advanced imaging technologies in ophthalmology, providing clinicians with precise, noninvasive options for early diagnosis and intervention. For more details, visit the article in JAMA Ophthalmology or review the study at source.