ESCRS - FP10.10 - Posterior Microphthalmos Vs Nanophthalmos : Role Of Biometric Measurements In Diagnosis And Managment : Case Series

Posterior Microphthalmos Vs Nanophthalmos : Role Of Biometric Measurements In Diagnosis And Managment : Case Series

Published 2025 - 43rd Congress of the ESCRS

Reference: FP10.10 | Type: Free paper | DOI: 10.82333/xt08-tr14

Authors: Shreya Saraogi* 1 , Naren Shetty 1 , Ravi Krishna Kanaradi 1 , Poorna Chandra B 2 , Swaminathan sethu 3

1CATARACT & REFRACTIVE,Narayana nethralaya,Bengaluru,India, 2Retina,Narayana nethralaya,Bengaluru,India, 3Grow lab,Narayana nethralaya,Bengaluru,India

Purpose

Nanophthalmos and posterior microphthalmos are rare developmental ocular disorders characterized by a reduced axial length. Despite their similarities, these conditions have distinct anatomical and clinical implications, particularly in their association with complications such as angle-closure glaucoma and retinal pathology. This study aims to highlight the role of ocular biometry in differentiating these entities and guiding appropriate management.

Setting

A retrospective observational study conducted at Ibn elhaytham Center , Algiers 

Data was extracted from Oyoun Software data base at the center , keywords used (Nanophthalmos - Posterior Microphthalmos) for patients from 2009 to 2024

Methods

A retrospective observational study was conducted on 15 patients (30 eyes) diagnosed with nanophthalmos or posterior microphthalmos at the Ibn Elhaytham Center, Algeria. Patients were categorized based on axial length (<20.5 mm), anterior chamber depth (ACD), and corneal diameter. Key biometric parameters (BCVA, SE, Km, AL, WTW, CCT, ACD, LT, IOP) were analyzed alongside clinical associations such as hyperopia, amblyopia, crowded optic discs, chorioretinal folds, and glaucoma risk.

Results

Nanophthalmic eyes (20/30) exhibited significantly shallower ACD (<3mm) and higher incidence of angle-closure glaucoma (30% vs. 0% in posterior microphthalmos).
 
Posterior microphthalmic eyes (10/30) had normal ACD (>3mm) but were more frequently associated with macular folds (20%) and retinitis pigmentosa (20% vs. 0% in nanophthalmos).
 
Mean age at presentation was significantly lower in posterior microphthalmia (26.6 vs. 46.7 years for nanophthalmos), aligning with findings from Relhan et al.
 
The CCT (Central coorneal diameter) was thicker in nanophthalmos compared to Posterior Microphthalmos eyes
 
None of the Posterior microphthalmos patients had acute angle-closure glaucoma at presentation or during followup 

Conclusions

Biometric differentiation between nanophthalmos and posterior microphthalmos is crucial for accurate diagnosis and risk stratification. The high risk of angle-closure glaucoma in nanophthalmos justifies early prophylactic intervention, while posterior microphthalmos is more frequently associated with retinal complications. Understanding these distinctions enhances clinical decision-making and improves surgical outcomes.