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PHOTO ESSAY
Year : 2021  |  Volume : 1  |  Issue : 3  |  Page : 422

Multimodal imaging in a case of posterior microphthalmos


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 Submission20-Nov-2020
Date of Acceptance27-Feb-2021
Date of Web Publication02-Jul-2021

Correspondence Address:
Dr. Ramandeep Singh
Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh - 160012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3474_20

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  Abstract 


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 28];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 Top


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.[1] 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.[2],[3],[4] 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.[2]

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Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Carricondo PC, Andrade T, Prasov L, Ayres BM, Moroi SE. Nanophthalmos: A review of the clinical spectrum and genetics. J Ophthalmol 2018;9:2735465.  Back to cited text no. 1
    
2.
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.  Back to cited text no. 2
    
3.
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.  Back to cited text no. 3
    
4.
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.  Back to cited text no. 4
    


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