CT of acquired hyperopia with choroidal folds

Seven patients with an ophthalmologic diagnosis of acquired hyperopia with choroidal folds were evaluated by high-resolution axial CT of the orbits. Coronal, oblique coronal, and parasagittal reformations were obtained and the thickness of the optic nerve and morphologic appearance of the globes were assessed by measurement and subjective appearance. Flattening of the globe, which caused the globe to assume an ellipsoid shape, was seen in all 11 affected eyes. Mild to moderate optic nerve enlargement was also demonstrated in most patients. In six of 11 affected eyes a visible space was noted between the optic nerve and its sheath, implying expansion of the subarachnoid perineural compartment. These findings were not demonstrated in a control group of five patients scanned in a similar manner. Scans of a phantom revealed no evidence of CT-generated distortion. These findings may help to identify hyperopia with choroidal folds as a benign disease and eventually help to establish its cause.