To find the optimal parameter of retinal nerve fiber layer (RNFL) analysis in optical coherence tomography (OCT) for diagnosing glaucoma in children.

The study was comprised of 127 eyes of 84 patients (aged 6 to 18 years) who visited our institute between March 2006 and February 2008. Subjects were classified into normal, glaucoma suspect and glaucoma groups, and each eye was scanned using Stratus 3.0 OCT. Routine ophthalmic examinations including fundus examination, visual field test and OCT RNFL analysis were performed.

There were 55 normal eyes, 27 glaucoma suspect eyes and 45 glaucomatous eyes. The average RNFL thickness was the most useful parameter to differentiate between the glaucoma and non-glaucoma groups. The next most useful parameter was inferior average thickness, followed by superior RNFL thickness. The sensitivity and specificity of the new discriminant of the formula used were 78%, and 68.6%, respectively.

In OCT analysis, the average RNFL thickness is the most useful parameter in the diagnosis of glaucoma in children. The new discriminant of the formula is useful in the diagnosis of pediatric glaucoma patients.