Intraocular pressure and optical coherence tomography parameters in pediatric hydrocephalus: a comparative analysis of patients with and without shunts versus healthy controls.

AIM: To evaluate and compare intraocular pressure (IOP) and optical coherence tomography(OCT) parameters in patients with hydrocephalus with and without shunt operations, versus healthy controls. METHODS: This study includes pediatric patients with hydrocephalus (HC) who were followed at our Pediatric Ophthalmology and Strabismus Unit. Of the 60 patients included, 30 had HC, and30 were healthy controls. Detailed ophthalmologic examinations including IOP, and central corneal thickness (CCT), retinal nerve fiber layer (RNFL), and ganglion cell complex (GCC)thickness were performed. RESULTS: Sixty subjects were included in the study (30 HC, 30 control). Patients with HC who had undergone shunt placement were categorized as shunt-positive (shunt+), and those without as hunt were categorized as shunt-negative (shunt-). The mean age of the participants was11.16±4.22 (median: 11, 3-18) years, and 52% (n=31) of them were female. In the HC group, 21patients (70%) had undergone shunt operations, and nine patients (31%) had not. Both groups had similar refractive error and visual acuities (p>0.05). The HC group had significantly higher IO P values compared with the controls (17.95±4.58 vs. 15.83±3.34; p=0.005). A comparison between groups showed no significant difference in IOP measurements between patients with HC with and without shunts (p>0.05). The mean RNFL thickness was significantly lower in patients with and without shunts compared with controls (p=0.003 and p=0.032, respectively). There was a significant difference between the groups in terms of mean GCC, (p<0.001). Post-hoc analysis revealed significantly lower GCC thicknesses in both HC groups compared with the controls (both p<0.001). CONCLUSION: In this pediatric HC cohort, IOP was higher and OCT measures, including RNF Land GCC thickness, were lower than in healthy controls. Monitoring IOP and OCT parameters in children with hydrocephalus, regardless of shunt status, may support early detection and follow-up of potential optic nerve damage.