Differences of megalopapilla and normal sized disk with age—an optical coherence tomography analysis

Abstract Purpose To compare the optic disks of children and adults with megalopapilla using optical coherence tomography (OCT). Subjects and Methods: We conducted a case–control study of subjects with megalopapilla and normal sized disks seen between February 2013 and July 2015 at the Hospital da Luz, Lisbon. All subjects and controls were imaged with spectral domain OCT, and optic nerve head (ONH) parameters were evaluated. The main outcome measures were rim area, cup:disk ratio, and cup volume. Results A total of 168 eyes of 168 subjects were included: 78 with megalopapilla (39 children / 39 adults) and 90 (45/45) with normal sized disks. For the same ONH area, children had a higher rim area (P = 0.000), a smaller cup:disk ratio (P = 0.001), and a smaller cup volume (P = 0.001) than adults. Children with megalopapilla had a larger cup:disk ratio (P = 0.000) and a larger cup volume (P = 0.000) than normal-sized disks. Conclusions In this study cohort, compared to adults with the same disk size, children (with megalopapilla or normal-sized disks) had a larger rim area and smaller cup. These findings suggest that enlargement of the cup of the optic disk and reduction of the rim area can occur through life.