MORPHOMETRY OF THE OPTIC-NERVE AND RETINAL-VESSELS IN CHILDREN BY COMPUTER-ASSISTED IMAGE-ANALYSIS OF FUNDUS PHOTOGRAPHS

Background: The retinal fundus in childhood has a different morphology than in adulthood. Existing methods are not suitable for evaluation o f fundus photographs from children. Therefore, a new method for quanti tative analysis of fundus morphology utilizing a personal computer-ass isted digital mapping system was developed. Methods: a CCD flatbed sca nner is used to digitize fundus photographs, producing computer images which are analyzed on an IBM/AT computer. Area measurements of the op tic disc, excavation and peripapillary crescent are made, as well as d eterminations of the length, branching, tortuosity and distribution of the retinal vessels on the fundus surface. Results: Determination of the inter- and intra-observer variability of the computer-assisted ima ge analysis technique demonstrated good reproducibility. The method is demonstrated using fundus photographs of six normal children and six children with the fetal alcohol syndrome. Typical variations in appear ance of optic disc and retinal vessels are seen. Conclusion: The syste m is unique in measuring both the optic nerve head and the retinal ves sels and is therefore especially useful for detailed studies of normal and abnormal development of these structures in children.