{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T19:47:16Z","timestamp":1777405636433,"version":"3.51.4"},"reference-count":29,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: Children with large optic discs are frequently referred to as glaucoma suspects. The aim of this study was to longitudinally analyze and compare the peripapillary retinal nerve fiber layer (pRNFL) thickness and minimum rim width (BMO-MRW) of large optic discs in children (LOD-C), normal sized optic discs in children (NOD-C) and large optic discs in adults (LOD-A) in order to evaluate longitudinal structural stability and intergroup differences in optic nerve head morphology. Methods: Briefly, 85 LOD-C, 72 NOD-C and 78 LOD-A were included. Large optic discs were identified based on a Bruch\u2019s membrane opening (BMO) area threshold of \u22652.5 mm2. pRNFL thickness and minimal rim width (BMO-MRW) of optical coherence tomography (OCT) were compared between baseline and follow-up examination at a median of 1.4 [1.0; 2.5] years. Results: Mean global pRNFL thickness and BMO-MRW did not significantly change during the follow-up period. LOD-C showed a significant increase in pRNFL thickness in the superonasal segments, NOD-C in the nasal segments. pRNFL and BMO-MRW of LOD-A decreased during the follow-up period. However, there was a higher variance of pRNFL thickness change in LOD-C as compared with NOD-C in the superotemporal and inferonasal segments. Four optic discs in the LOD-A group showed a glaucomatous conversion, whereas none of the discs of LOD-C or NOD-C progressed to glaucoma. Conclusions: Children with large optic discs presented with stable pRNFL and BMO-MRW and without clinical progression to glaucoma at follow-up. A careful interpretation of the OCT measurement results is necessary when assessing pediatric large optic discs, as growth and remodelling may impair the accuracy of segmentation and automated classification algorithms.<\/jats:p>","DOI":"10.3390\/jcm15093348","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:55:39Z","timestamp":1777370139000},"page":"3348","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Assessment of Large Optic Discs in Children and Adults Using Spectral Domain Optical Coherence Tomography"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9684-7753","authenticated-orcid":false,"given":"Julia V.","family":"Stingl","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Walter","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cordula","family":"Braun","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6136-4990","authenticated-orcid":false,"given":"Simon C.","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Wolters","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4596-6947","authenticated-orcid":false,"given":"Jasmin","family":"Rezapour","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9560-0524","authenticated-orcid":false,"given":"Felix M.","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3867-2350","authenticated-orcid":false,"given":"Achim","family":"Fie\u00df","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander K.","family":"Schuster","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0949-4268","authenticated-orcid":false,"given":"Esther M.","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"ref_1","first-page":"2012","article-title":"Human optic nerve fiber count and optic disc size","volume":"33","author":"Jonas","year":"1992","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e301","DOI":"10.1111\/aos.12545","article-title":"Megalopapilla in children: A spectral domain optical coherence tomography analysis","volume":"93","author":"Lee","year":"2015","journal-title":"Acta Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2203","DOI":"10.1016\/S0042-6989(97)00368-4","article-title":"Automated visual field examination in children aged 5\u20138 years: Part I: Experimental validation of a testing procedure","volume":"38","author":"Tschopp","year":"1998","journal-title":"Vis. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1167\/tvst.14.4.24","article-title":"New Threshold for Large Optic Discs in Children Using Bruch\u2019s Membrane Opening Area","volume":"14","author":"Stingl","year":"2025","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Larsson, E., Molnar, A., and Holmstr\u00f6m, G. (2018). Repeatability, reproducibility and interocular difference in the assessments of optic nerve OCT in children- a Swedish population-based study. BMC Ophthalmol., 18.","DOI":"10.1186\/s12886-018-0940-x"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/S0161-6420(91)32234-6","article-title":"Correlation of the optic disc size to glaucoma susceptibility","volume":"98","author":"Jonas","year":"1991","journal-title":"Ophthalmology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1007\/s00417-018-4011-z","article-title":"Prevalence of glaucoma in Germany: Results from the Gutenberg Health Study","volume":"256","author":"Nickels","year":"2018","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1007\/BF00181778","article-title":"Are large optic nerve heads susceptible to glaucomatous damage at normal intraocular pressure? A three-dimensional study by laser scanning tomography","volume":"230","author":"Burk","year":"1992","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_9","first-page":"807","article-title":"Optic disc size and progression of visual field damage in patients with normal-tension glaucoma","volume":"7","author":"Hayamizu","year":"2013","journal-title":"Clin. Ophthalmol."},{"key":"ref_10","first-page":"2991","article-title":"The Optic Nerve Head as a Biomechanical Structure: Initial Finite Element Modeling","volume":"41","author":"Bellezza","year":"2000","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e14.e1","DOI":"10.1016\/j.jaapos.2019.09.019","article-title":"Differences of megalopapilla and normal sized disk with age\u2014An optical coherence tomography analysis","volume":"24","author":"Gama","year":"2020","journal-title":"J. Am. Assoc. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1016\/j.jcjo.2018.02.025","article-title":"Optical coherence tomography analysis of the inner retinal layers in children","volume":"53","author":"Gama","year":"2018","journal-title":"Can. J. Ophthalmol."},{"key":"ref_13","first-page":"82","article-title":"Measurement of the Inner Retinal Layers of Megalopapilla by Optical Coherence Tomography","volume":"6","author":"Gama","year":"2017","journal-title":"Med. Hypothesis Discov. Innov. Ophthalmol."},{"key":"ref_14","first-page":"579","article-title":"Morphometric characteristics of the optical disc and thickness of retinal nerve fibre layer using Cirrus 5000 optical coherence tomography in healthy patients attending the National Institute of Ophthalmology","volume":"94","year":"2019","journal-title":"Arch. Soc. Esp. Oftalmol. (Engl. Ed.)"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1097\/IJG.0b013e318279b3af","article-title":"Optic disc and retinal nerve fiber layer thickness descriptive analysis in megalopapilla","volume":"23","author":"Costa","year":"2014","journal-title":"J. Glaucoma"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2610","DOI":"10.4103\/ijo.IJO_2480_21","article-title":"Case series: Megalopapillae in twins\u2014Congenital or hereditary?","volume":"70","author":"Sharma","year":"2022","journal-title":"Indian J. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1001\/archopht.1989.01070010858029","article-title":"Racial differences in optic nerve head parameters","volume":"107","author":"Chi","year":"1989","journal-title":"Arch. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1001\/archopht.1980.01020040905024","article-title":"Aging of the optic nerve","volume":"98","author":"Dolman","year":"1980","journal-title":"Arch. Ophthalmol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/0002-9394(84)90509-9","article-title":"The effect of age on the nerve fiber population of the human optic nerve","volume":"97","author":"Balazsi","year":"1984","journal-title":"Am. J. Ophthalmol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"8095","DOI":"10.1167\/iovs.13-12634","article-title":"Age-related change in retinal nerve fiber layer thickness measured with spectral domain optical coherence tomography","volume":"54","author":"Celebi","year":"2013","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.survophthal.2025.06.008","article-title":"Age-related changes in optical coherence tomography glaucoma-related parameters: A systematic review","volume":"71","author":"Verbruggen","year":"2026","journal-title":"Surv. Ophthalmol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"655","DOI":"10.3109\/08820538.2016.1157613","article-title":"Relationship between Age and Retinal Nerve Fiber Layer Thickness in Normal Children","volume":"32","author":"Hong","year":"2017","journal-title":"Semin. Ophthalmol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"100219","DOI":"10.1016\/j.apjo.2025.100219","article-title":"Longitudinal evaluation of Bruch\u2019s membrane opening-minimum rim width in Chinese children: The Hong Kong Children Eye Study","volume":"14","author":"Li","year":"2025","journal-title":"Asia-Pac. J. Ophthalmol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.ajo.2012.06.012","article-title":"Reproducibility of optical coherence tomography measurements in children","volume":"155","author":"Altemir","year":"2013","journal-title":"Am. J. Ophthalmol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1080\/01658107.2017.1349806","article-title":"Optic Nerve Head Parameters Measured with Spectral-Domain Optical Coherence Tomography in Healthy Turkish Children: Normal Values, Repeatability, and Interocular Symmetry","volume":"42","author":"Toygar","year":"2018","journal-title":"Neuroophthalmology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"100840","DOI":"10.1016\/j.preteyeres.2020.100840","article-title":"A neuroglia-based interpretation of glaucomatous neuroretinal rim thinning in the optic nerve head","volume":"77","author":"Lee","year":"2020","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.preteyeres.2015.06.003","article-title":"Glia-neuron interactions in the mammalian retina","volume":"51","author":"Vecino","year":"2016","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1016\/j.ophtha.2015.06.001","article-title":"Bruch\u2019s Membrane Opening Minimum Rim Width and Retinal Nerve Fiber Layer Thickness in a Normal White Population: A Multicenter Study","volume":"122","author":"Chauhan","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.ogla.2023.11.002","article-title":"Predictors of Glaucomatous Progression in Individuals with Small and Large Optic Discs","volume":"7","author":"Ho","year":"2024","journal-title":"Ophthalmol. Glaucoma"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/9\/3348\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T10:33:04Z","timestamp":1777372384000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/9\/3348"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":29,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["jcm15093348"],"URL":"https:\/\/doi.org\/10.3390\/jcm15093348","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,28]]}}}