Nanophthalmous Microphthalmous Thick Sclera Choroidal Congestion - Chorioretinal Folds
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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.
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 903 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 605 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 580 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 533 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 599 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 594 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 510 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 526 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 496 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 455 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 560 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 565 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 492 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 466 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 456 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 516 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 604 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 510 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 469 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 434 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 514 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 497 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyesvu 528 fois67-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)
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasoundvu 555 fois
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasoundvu 595 fois
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasoundvu 725 fois
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasoundvu 728 fois
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasoundvu 760 fois
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasoundvu 945 fois
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Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasoundvu 942 fois
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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.
