Longitudinal retinal changes in children and young adults from the Northern Ireland Childhood Errors of Refraction (NICER) Study

Research output: Chapter in Book/Report/Conference proceedingConference contribution


Aims: The purpose of this study is to investigate the longitudinal changes of cup-to-disc (CD) and arteriole-to-venule (A/V) ratios over time in children and to investigate the influence changes in refractive error and body composition may have on these parameters.
Materials and Methods: Images were captured at Phase 1 of the NICER study when participants were aged 6-7 and 12-13 years. The follow-up images were taken nine years later on the same children aged 15-16 and 21-22 years using the same image capture technique. In addition, image quality, cup depth and peripapillary atrophy were noted. The CD and A/V ratios were measured using ImageJ software using standardized retinal imaging measures. Measures of height and waist circumference were obtained and BMIs calculated. 
Results: No statistically significant differences were found for CD or A/V ratios between Phases 1 and 4 (all p>0.05) for either cohort. There was no statistically significant difference in change in CD or A/V ratios between refractive groups or between body composition categories for either cohort (ANOVA all p>0.05). Additionally, linear regression analysis showed no association between change in CD or A/V ratios with change in refractive error, axial length or BMI for both younger and older cohorts.
Conclusion: There was no statistically significant change in CD ratio over time for the younger or older cohort (average CD ratio of 0.28 across both cohorts at both time points). No statistically significant change occurred with A/V ratios over time for either cohort. The average A/V ratio for cohorts was approximately 0.79 (4:5 A/V) which is different to the typically described 2:3 relationship often reported. There was no significant correlation between changes in CD or A/V ratios with changing refractive error or changing axial length indicating that growth of retinal structures is at a similar rate to maintain constant ratios. Changes in BMI with time were not reflected in changes in A/V ratio in either cohort.
Original languageEnglish
Title of host publicationNorthern Ireland Clinical Research Network
Publication statusPublished (in print/issue) - 15 Mar 2019


  • retina
  • optic disc
  • Retinal Vessels/pathology
  • refractive error
  • Children


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