Anterior Segment Characteristics In Patients With Posterior Microphthalmia : A Study Of 10 Eyes

Published 2024 - 42nd Congress of the ESCRS

Reference: FP05.11 | Type: Free paper | DOI: 10.82333/8y4a-b541

Authors: Fadila Lachkar* ¹ , Imane Serghini Ambari ¹ , Hassan Moutei ¹ , Ahmed Bennis ¹ , Fouad Chraibi ¹ , Meriem Abdellaoui ¹ , Idriss Benatiya Andaloussi ¹

¹ophtalmology,university hospital Hassan II,fez,Morocco

Purpose

In contrast to microphthalmia, which is characterized by a congenitally small eye with reduced globe volume and corneal diameters, posterior microphthalmia is a rarer and often unrecognized condition. It is marked by a shortened posterior segment with macular folds, while the anterior segment remains normal. The introduction of anterior segment OCT, corneal topography, and optical biometry has facilitated the identification of changes in the anterior segment associated with posterior microphthalmia.

The aim of our study was to characterize anterior segment changes in posterior microphthalmia and explore the feasibility of refractive surgery

Setting

Through a retrospective study conducted at the ophthalmology department of University Hospital Hassan II in Fes, spanning a period of 6 years from November 2017 to November 2023, we report on 10 cases involving five patients diagnosed with posterior microphthalmia.

Methods

We obtained demographic information, including gender, age, and morphology from each patient. All patients underwent a comprehensive ophthalmological evaluation, including refractive measurement, ocular biometry, corneal topography, macular and anterior segment SD-OCT, as well as OCT-angiography.

Results

The mean age at diagnosis was 13 years. All patients reported decreased visual acuity since childhood. Ophthalmologic examination of the ten eyes revealed a corrected visual acuity ranging from 1/10 to 4/10, and high hypermetropia with a mean refraction of +16.08 diopters. The mean keratometry was 50.60 diopters. Optical biometry showed reduced axial length, with a mean of 15.87 mm, deep anterior chamber (mean 3.04 mm), and normal lens thickness (mean 4 mm). Furthermore, we did not observe topographic criteria indicative of keratoconus in any of our patients. All patients had a normal anterior segment examination with normal corneal diameters. Fundus examination revealed pseudo-papillary edema, horizontal papillo-macular retinal folds.

Conclusions

Diagnosing posterior microphthalmia is challenging. It may clinically go unnoticed, especially when anterior segment dimensions are normal. This underscores the importance of systematic fundus examination, ocular biometry, and the use of anterior segment in hypermetropic patients to establish an early diagnosis and propose appropriate management. The corneal steepening found in our patients contrasted with a normal-depth anterior chamber, allowed for compensation of axial hypermetropia, thereby providing improved visual acuity for the patient. To conclude, patients with posterior microphthalmia could undergo correction with a phakic implant, leading to improved vision quality and a significant long-term reduction in amblyopia