Poster 254

by in  Poster Session 3

 Nanophthalmos in Children – Morphometric and Clinical Characterization

Sumita Agarkar; Nikunj Koladiya
Sankara Nethralaya
Chennai, India

 

Introduction: Nanophthalmos is a rare disorder characterised by short axial length and hyperopia .Lens is normal sized but large relative to a small globe leading to angle closure and glaucoma. Several posterior segment anomalies have also been reported. This study aims to describe morphometric and clinical characteristics of children with nanophthalmos

Methods: Electronic medical records of children under age of 18 years diagnosed as nanophthalmos, were retrospectively reviewed. Data which was collected included demographic details ,family history, history of consanguinity, visual acuity (VA), spherical equivalent (SPEQ), presence of any strabismus and amblyopia ,axial length (AXL), anterior chamber depth (ACD), lens thickness (LT), intra-ocular pressure, gonioscopy and posterior segment findings. Data from right eye was used for analysis

Results: A total of 88 children were identified. Mean age at presentation was 9.9 years. Mean SPEQ was +13.17 D. VA was between 6/6 – 6/18 in 55 children, between 6/18-6/60 in 28 children and <3/60 in 1 child. Four preverbal children’s VA was central, steady and maintained. Eighteen children had esotropia and 3 had exotropia. Mean AXL was 16.9 mm. Mean ACD was 2.95 mm. Mean LT was 3.84 mm. Fifteen children had occludable angles. Fourteen children underwent prophylactic peripheral iridotomy and 3 children required anti-glaucoma medication

Discussion: There is limited literature available on clinical characteristics of children with nanophthalmos The leading cause of visual impairment in our series was uncorrected refractive errors and amblyopia . This was compounded by the fact that mean age of presentation was at a relatively older age of 9 years.Nearly one in six children had a occludable angles on gonioscopy requiring intervention . This underlines the importance of gonioscopy and close follow up in these children . To the best of our knowledge this is the largest study examining children with nanophthalmos

Conclusion: Pediatric patients with nanophthalmos require comprehensive eye evaluation including gonioscopy. Most common presenting complaint is visual impairment. Nearly 20% of the patients may require intervention for occludable angles

References: 1.            Nowilaty SR, Khan AO, Aldahmesh MA, Tabbara KF, Al-Amri A, Alkuraya FS. and molecular characterization of clinically diagnosed posterior microphthalmos. Am J Ophthalmol. 2013 Feb;155(2):361-372
2. Relhan N, Jalali S, Pehre N, Rao HL, Manusani U, Bodduluri L. High-hyperopia database, part I: clinical characterisation including morphometric (biometric) differentiation of posterior microphthalmos from nanophthalmos. Eye (Lond). 2016 Jan;30(1):120-6
3. Khairallah M, Messaoud R, Zaouali S, Ben Yahia S, Ladjimi A, Jenzri S. Posterior segment changes associated with posterior microphthalmos. Ophthalmology. 2002 Mar;109(3):569-74

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