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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 Eyes899 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 Eyes602 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 Eyes577 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 Eyes530 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 Eyes596 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 Eyes590 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 Eyes507 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 Eyes523 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 Eyes494 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 Eyes452 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 Eyes556 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 Eyes563 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 Eyes489 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 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 Eyes602 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 Eyes507 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 Eyes467 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 Eyes509 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 Eyes494 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 Eyes525 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 Ultrasound553 views (0 votes)
Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound593 views (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound723 views (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound726 views (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound756 views (0 votes)
Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound943 views (0 votes)	Nanopthalmous (Microphthalmous) Chorioretinal Folds and Choroidal Thickening Both Eyes B-Scan Ultrasound940 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.