The Pathogenesis and Treatment of Complications in Nanophthalmos

Abstract

Microphthalmos is a type of developmental disorder ophthalmopathy, which can occur isolated or combined with other ocular malformations and can occur secondary to a systemic syndrome. Nanophthalmos is one of the clinical phenotypes of microphthalmos. Due to the special and complex structure of nanophthalmic eyes, the disorder is often associated with many complications, including high hyperopia, angle-closure glaucoma, and uveal effusion syndrome. The management of these complications is challenging, and conventional therapeutic methods are often ineffective in treating them. The purpose of this paper was to review the concept of nanophthalmos and present the latest progress in the study of the pathogenesis and treatment of its complications. As it is considerably challenging for ophthalmologists to prevent or treat these nanophthalmos complications, timely diagnosis and a suitable clinical treatment plan are vital to ensure that nanophthalmos patients are treated and managed effectively.

Prevalence of Complications in Eyes With Nanophthalmos or Microphthalmos: A Systematic Review and Meta-analysis

“…Microphthalmos and nanophthalmos are uncommon ocular conditions where the size of the eye is smaller than that of the normal population. [1][2][3] Axial length, the parameter most commonly used to measure the ocular size, is shorter in these eyes. Microphthalmos is divided into simple microphthalmos which has no associated ocular malformations, or complex microphthalmos, in which ocular malformations or systemic syndromes are present.…”

“…Microphthalmos is divided into simple microphthalmos which has no associated ocular malformations, or complex microphthalmos, in which ocular malformations or systemic syndromes are present. 1,3 Nanophthalmos is a subset of simple microphthalmos where, in addition to the shorter axial length, the eye also has a thickened sclera and choroid. 2 This is thought to occur as a result of an abnormality in the arrangement of the collagen brils.…”

“…11 When there is a relative shortening of either the anterior or posterior segments of the eye, this is known as relative anterior or posterior microphthalmos respectively. 1 Other parameters measured for microphthalmos and/or nanophthalmos include; shallow anterior chamber, high hyperopia, posterior wall thickness greater than 1.7mm and a high lens/eye volume ratio. 1,2 Microphthalmos and nanophthalmos present several vision-related challenges to ophthalmologists which can occur spontaneously, or after surgery.…”

“…1 Other parameters measured for microphthalmos and/or nanophthalmos include; shallow anterior chamber, high hyperopia, posterior wall thickness greater than 1.7mm and a high lens/eye volume ratio. 1,2 Microphthalmos and nanophthalmos present several vision-related challenges to ophthalmologists which can occur spontaneously, or after surgery. Spontaneous vision-related problems are high hyperopia, angle-closure glaucoma, uveal effusion syndrome, and retinal detachment.…”

“…1,2 Other associations include corneal steepening, enlarged foveal avascular zone, optic disc drusen, central retinal vein occlusion, and chorioretinal folds. 1,2,11 Surgery in nanophthalmos and microphthalmos is associated with higher rates of complications and poorer visual outcomes. 12 Cataract surgery is associated with complications such as anterior uveitis, uveal effusions, corneal decompensation, retinal detachment, cystoid macular oedema, choroidal haemorrhage, vitreous haemorrhage, and aqueous misdirection.…”