|Year : 2021 | Volume
| Issue : 3 | Page : 422
Multimodal imaging in a case of posterior microphthalmos
Uday Tekchandani1, Bruttendu Moharana2, Ankur Singh3, Ramandeep Singh1
1 Department of Ophthalmology, Advanced Eye Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Ophthalmology, Drishti Eye Hospital, Panchkula, Haryana, India
3 Department of Ophthalmology, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India
|Date of Submission||20-Nov-2020|
|Date of Acceptance||27-Feb-2021|
|Date of Web Publication||02-Jul-2021|
Dr. Ramandeep Singh
Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh - 160012
Source of Support: None, Conflict of Interest: None
Keywords: Multimodal imaging, nanophthalmos, posterior microphthalmos
|How to cite this article:|
Tekchandani U, Moharana B, Singh A, Singh R. Multimodal imaging in a case of posterior microphthalmos. Indian J Ophthalmol Case Rep 2021;1:422
|How to cite this URL:|
Tekchandani U, Moharana B, Singh A, Singh R. Multimodal imaging in a case of posterior microphthalmos. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Jul 26];1:422. Available from: https://www.ijoreports.in/text.asp?2021/1/3/422/320076
An 18-year-old boy was referred to our retina clinic with a presumptive diagnosis of papilledema. He had diminution of vision in both eyes since childhood with the best-corrected visual acuity of 6/36 with refractive correction of +15 D in both eyes. Intraocular pressure was 28 mmHg and 30 mmHg in the right and left eye, respectively. Horizontal white-to-white diameter of 11.7 mm in both eyes was measured on the vernier caliper. Axial length on A-scan was 20.38 mm and 20.40 mm in the right and left eye, respectively. Anterior chamber depth of 3.17 mm and 3.30 mm was documented in the right and left eye, respectively. The funduscopic evaluation revealed bilateral small, hyperemic, edematous-looking disc with loss of optic cup, and a retinal fold spanning from disc margin to fovea in the region of the papillomacular bundle [black arrows, [Figure 1]a and [Figure 1]b. A clinical diagnosis of posterior microphthalmos with pseudopapilledema was made. Optical coherence tomography showed sectoral edema and folding in the outer retinal layers in the area of clinically seen retinal folds [white arrows, [Figure 1]c and [Figure 1]d]. Orbital magnetic resonance imaging revealed thickened sclera [orange arrows, [Figure 1]e].
|Figure 1: Fundus examination of a case of posterior microphthalmos shows bilateral optic disc edema and retinal fold spanning from disc margin to fovea in the region of the papillomacular bundle (black arrows, a and b). Optical coherence tomography shows sectoral edema and folding in the outer retinal layers in the area of clinically seen retinal folds (white arrows, c and d). Orbital magnetic resonance imaging reveals thickened sclera (orange arrows, e)|
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| Discussion|| |
Nanophthalmos is a rare condition of a phenotypically small but structurally normal eye, with a short axial length due to small anterior and posterior segments, thickened choroid, sclera, and normal lens volume. Posterior microphthalmos is a subtype of nanophthalmos characterized by a short axial length due to posterior segment shortening but normal anterior chamber dimensions. Retinal folds are seen in posterior microphthalmic eyes due to retarded growth of the scleral, choroidal, and retinal pigment epithelial layers, which causes an excess of the neurosensory retina to become redundant and fold on itself to accommodate this retardation in growth.,, The main causes of low vision are papillomacular retinal fold and hyperopic amblyopia. Correct diagnosis, regular follow-up, and early interventions for hyperopia, amblyopia, and uveal effusion help in improving the visual function.
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There are no conflicts of interest.
| References|| |
Carricondo PC, Andrade T, Prasov L, Ayres BM, Moroi SE. Nanophthalmos: A review of the clinical spectrum and genetics. J Ophthalmol 2018;9:2735465.
Khairallah M, Messaoud R, Zaouali S, Ben Yahia S, Ladjimi A, Jenzri S. Posterior segment changes associated with posterior microphthalmos. Ophthalmology 2002;109:569-74.
Nowilaty SR, Mousa A, Ghazi NG. The posterior pole and papillomacular fold in posterior microphthalmos: Novel spectral-domain optical coherence tomography findings. Ophthalmology 2013;120:1656-64.
Park SH, Ahn YJ, Shin SY, Lee YC. Clinical features of posterior microphthalmos associated with papillomacular fold and high hyperopia. Clin Exp Optom 2016;99:590-3.