Unmeasurable small size superficial and deep foveal avascular zone in nanophthalmos: the Collaborative Nanophthalmos OCTA Study

Abstract

AimTo study the macular structure and vasculature in consecutive nanophthalmic eyes using optical coherence tomography angiography.MethodsThis is a prospective, multicentre, cross-sectional study of patients with nanophthalmos (one or both eyes). The superficial and deep foveal avascular zones (FAZ) were measured both manually and with the machine’s built-in automated measurement tool. Correlations between best corrected visual acuity (BCVA), central macular thickness (CMT) and subfoveolar choroidal thickness (SFCT) were calculated.ResultsSixty-five eyes of 35 subjects (16 men and 19 women) with a mean age of 37.4 years were analysed. The mean±SD of refractive error was 14.3±3.2 dioptres, axial length was 16.4±1.6 mm, CMT was 410.2±128.3 µm and SFCT was 450.1±108.3 µm. FAZ was unmeasurable small size in both the superficial and deep capillary plexus in all eyes, along with tortuosity of the superficial foveal capillaries and large vessels. Foveal folds were present in 29 eyes. Disc drusen was detected in 27 eyes and was absent in 31 eyes, while fundus autofluorescence was positive in 17 and negative in 24 eyes. BCVA varied from 20/20 to 20/800, with a mean of 20/76. Using Spearman’s correlation, logarithm of the minimum angle of resolution BCVA correlated negatively with axial length (r=−0.30; p=0.015).ConclusionsFAZ attenuation, capillary tortuosity, foveal folds and thickened subfoveal choroid characterise the nanophthalmic macula. These findings may result from a redundant retina and the absence of apoptotic foveolar retraction because of developmental arrest of the optic vesicle after closure of the embryonic fissure.

Uveal Effusion Syndrome: Clinical Characteristics, Outcome of Surgical Treatment, and Histopathological Examination of the Sclera

“…During a mean follow-up duration of 65.3 months, the final BCVA improved or stabilized in 89.6% of eyes; however, OCT/OCTA imaging revealed that the extent of improvement was limited by photoreceptor and pigment epithelial damage resulting from macular dysplasia or chronic retinal detachment. The OCTA role in defining macular status and visual potential is consistent with Mansour's ( 23 ) findings in nanophthalmos. In addition, in our nanophthalmos group, secondary glaucoma combined with optic atrophy was also the main reason for poor final vision.…”

Association between axial length and choroidal thickness in early age-related macular degeneration

“…This suggests that light-induced CCT changes may affect scleral growth, and then, AL. However, further studies are required to validate this suggestion, considering the lack of pathohistological evidence collated over time [22]. Moreover, gene-environment interactions may also play a role in AL elongation and myopia development [23].…”

Surgical Approaches to Serous Retinal Detachment With Retina–Lens Touch in Eyes With Nanophthalmos

“…Special anatomic features of nanophthalmos. [5][6][7][8][9][10][11][12][13][14][15][16][17][18] zonular dialysis occurred after a cotton applicator was applied to the injection site in an effort to control the reflux of hyaluronic acid or air. The lens dislocated into the vitreous cavity in Cases 4 and 5 after the eye was reinflated with a balanced salt solution injected through a limbal incision.…”

“…These eyes have very anterior insertion of the retina, a large lens, short zonules, a shallow anterior chamber (AC) (with a propensity for angle closure), and a noticeably thickened sclera and choroid (Figure 1). [5][6][7][8][9][10][11][12][13][14][15][16][17][18] Vitrectomy is dangerous because it can result in peripheral holes (anterior retinal insertion), 12 which can cause an exudative RD to become more complex and require silicone oil tamponade or multiple surgical procedures. 12,13 In this case series, we describe the anatomic and visual results of surgical procedures for serous RD with retina-lens touch in eyes with nanophthalmos.…”