Multimodal imaging in Nanophtalmos.

Author: Meher Henchiri (Tunisia)

Co-authors: Rahma Saidane, Racem Choura, Asma Khallouli, Dhouha Gouider, Afef Maalej, Riadh Rannen

Purpose

To describe ocular findings in Nanophtalmos using multimodal imaging techniques .

Setting/Venue

Department of Ophthalmology of the Military Hospital of Tunis, Tunisia.

Methods

We conducted a cross-sectional study including 8 eyes of 4 patients with nanophtamos between September 2019 and April 2021. Refractive error/spherical equivalent was calculated. All included individuals underwent a complete ophthalmic examination including visual acuity, anterior and posterior segment examination. A-scan ultrasound biometry, B-scan ultrasonography, Ultrasound Bio Microscopy (UBM), Spectral Domain Optical Coherence Tomography (SD-OCT) and OCT Angiography (OCTA) were performed.

Results

The mean age was 36.75 years (18-56 years). The study included 2 females and 2 males. Mean refractive error was +13 diopters (+9.50 - +17.00). The mean logMAR best-corrected visual acuity was 0.51 (0.33-0.82). Mean corneal diameter was 9.06±0.9 mm. Using A- ultrasound biometry, the mean axial length was 15.68 mm with shallow anterior chamber (mean 1.80 mm) and a thick lens (mean 4.6 mm). UBM examination showed shallow anterior chamber, narrow iridocorneal angle and anterior rotation of the lens-iris diaphragm. B-mode ultrasound showed sclera-choroidal thickening with an average of 550 μm. Fundus examination showed papillomacular folds and crowded optic discs. The OCT B-scan of the macula showed bilateral retinal folds with disappearance of the foveolar depression. OCTA showed marked narrowing of the foveal avascular zone affecting the superficial and deep plexuses with normal vessel densities.

Conlusions

Nanophthalmos is a rare congenital pathology. It is classically bilateral. The diagnosis of posterior microphthalmia is primarily based on clinical examination. The multimodal approach helps confirm the diagnosis and provide pathophysiological explanations of this condition.

Financial Disclosure

The authors declare no conflict of interest.

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