Objective Quantification Of Pediatric Lens Opalescence And Its Bearing On The Visual Outcome: An Oct-Based Study

Purpose: The study aimed to quantify the opalescence of the pediatric cataractous lens using swept-source optical coherence tomography (OCT) and study its relation to clinical parameters.

Setting: Tertiary care government teaching hospital

Design: Prospective consecutive case series

Consecutive pediatric patients aged 0-12 years presenting with cataracts were recruited over one year. Imaging of the lens was performed preoperatively on the swept source Optical Coherence Tomography system (CASSIA2 ASOCT; Tomey, Nagoya, Japan). Whole lens and nuclear densities were calculated on the captured images and correlated with the patient's clinical parameters and visual acuity.

Fifty children (80 eyes) with an average age of 6.6 ± 2.73 years (Range 5 months – to 12 years) diagnosed with cataracts were successfully imaged on the OCT. A positive correlation was obtained between average lens densities and lower preoperative visual acuity of the patients (r=0.22; p=0.09), and a significant positive correlation between average nuclear densities and preoperative visual acuity of the patients (r=0.39; p=0.002). There was a very weak correlation between the lens or nuclear densities and the post-operative visual acuity (r=0.2; and 0.3; p =0.4 and 0.2). 

The swept source ASOCT is an excellent tool for objectively and quantitatively evaluating lens opacity in children. We propose that this quantification can be used to automate algorithms for the detection and screening of pediatric cataracts. It can help to assess cataract progression in clinical and research settings.