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Nanophthalmous Microphthalmous Thick Sclera Choroidal Congestion - Chorioretinal Folds 67-year-old woman was seen by me in the office on August 2, 2010. She has had microphthalmos/nanophthalmos and I saw her initially in January of 2005 at which point her vision was reasonable. I also saw her in 2003. The left eye is a little bit of a lazy eye and she has had difficulty with amblyopia in that eye from strabismus. Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. IOP: OD 15, OS 16. SLIT EXAMINATION: There is 3+ nuclear sclerosis in both eyes. Also the anterior chamber does look crowded. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.2. There is no posterior vitreous separation. I can see though the retinal vessels are tortuous and the retina does look elevated in the periphery. OS: Vertical C/D ratio is 0.4. There is no posterior vitreous separation. Again the retinal vessels look tortuous and there is some, what looks like retinal evaluation in the periphery. OCT SCAN: The OCT scan shows the retina to be slightly thick in both eyes. The average thickness in the right eye is 346 microns. The left eye has 361 microns. The OCT scan shows what looks to be choroidal congestion. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows no abnormal pigment epithelial damage in the macula with normal filling of the retinal vessels and no irregular hyperfluorescence. Her choroid is about two to three times thicker. She had choroid in the sclera, are thick all the way around, however, positioning her I’m looking at 6 o’clock and laying her back and sitting her up, I don’t see any accumulation of fluid either in the subretinal space or in the choroidal space. IMPRESSION: 1. NANOPHTHALMOS – BOTH EYES 2. POSSIBLE CHOROIDAL CONGESTION – BOTH EYES DISCUSSION: I explained to the patient that I don’t see any choroidal effusions in either eye, but I am afraid that she may be on the early stages of developing choroidal effusions associated with her nanophthalmos. I told her I would see her back in about three to six months.
Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes838 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes541 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes514 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes487 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)
Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes547 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes534 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes441 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes495 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)
Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes451 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes396 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes499 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes528 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)
Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes430 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes412 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes407 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes483 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)
Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes540 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes432 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes423 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes388 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)
Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes464 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes454 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes475 views67-year-old woman with microphthalmos/nanophthalmos Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound516 views (0 votes)
Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound538 views (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound669 views (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound684 views (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound705 views (0 votes)
Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound888 views (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound888 views (0 votes)
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67-year-old woman was seen by me in the office on August 2, 2010. She has had microphthalmos/nanophthalmos and I saw her initially in January of 2005 at which point her vision was reasonable. I also saw her in 2003. The left eye is a little bit of a lazy eye and she has had difficulty with amblyopia in that eye from strabismus. Her vision has gradually been getting a little bit worse, especially in the right eye. Also the anterior chamber is getting crowded and there is concern about the need for cataract surgery. She has one sister and one cousin who also have nanophthalmos. VISUAL ACUITY: OD 20/50, OS 20/80. IOP: OD 15, OS 16. SLIT EXAMINATION: There is 3+ nuclear sclerosis in both eyes. Also the anterior chamber does look crowded. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.2. There is no posterior vitreous separation. I can see though the retinal vessels are tortuous and the retina does look elevated in the periphery. OS: Vertical C/D ratio is 0.4. There is no posterior vitreous separation. Again the retinal vessels look tortuous and there is some, what looks like retinal evaluation in the periphery. OCT SCAN: The OCT scan shows the retina to be slightly thick in both eyes. The average thickness in the right eye is 346 microns. The left eye has 361 microns. The OCT scan shows what looks to be choroidal congestion. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows no abnormal pigment epithelial damage in the macula with normal filling of the retinal vessels and no irregular hyperfluorescence. Her choroid is about two to three times thicker. She had choroid in the sclera, are thick all the way around, however, positioning her I’m looking at 6 o’clock and laying her back and sitting her up, I don’t see any accumulation of fluid either in the subretinal space or in the choroidal space. IMPRESSION: 1. NANOPHTHALMOS – BOTH EYES 2. POSSIBLE CHOROIDAL CONGESTION – BOTH EYES DISCUSSION: I explained to the patient that I don’t see any choroidal effusions in either eye, but I am afraid that she may be on the early stages of developing choroidal effusions associated with her nanophthalmos. I told her I would see her back in about three to six months.