Serous macular detachment in nanophthalmos: A manifestation of pachychoroid spectrum

The purpose of this article is to report serous macular detachment (SMD) similar to that seen in central serous chorioretinopathy (CSCR) in patients with nanophthalmos.

It is a retrospective case series from a tertiary eye care center in India. Multi modal imaging features of eyes with serous macular detachment in patients with nanophthalmos including colour fundus photographs, short wave autofluorescence, fundus fluorescein angiography and optical coherence tomography were studied. In addition axial length, anterior chamber depth, lens thickness and subfoveal choroidal thickness were measured. The eyes were treated with laser photocoagulation to the focal leak seen on fluorescein angiography. The patients were followed up for 12-18 months.

Three eyes of three patients having serous macular detachment in nanophthalmos were identified. All three eyes had axial length <21mm, subfoveal choroidal thickness >450 microns and a focal leak on fluorescein angiography. Two eyes had serous pigment epithelial detachments underneath the SMD as well. Two eyes had peripheral pigmentary changes due to resolved subretinal fluid. The SMD resolved completely in two eyes and partially in one eye following focal laser photocoagulation.

Serous macular detachments bearing features similar to that of CSCR can occur in the setting of nanophthalmos. These may represent manifestation of thick choroid or may represent forme fruste choroidal effusion.