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Retinal arcades in posterior microphthalmos: biometric correlation
Ramesh Venkatesh1, Pranjal Mishra1, Harshita Nahata1
1Department of Retina and Vitreous, Narayana Nethralaya, Karnataka, India.
Clinical Relevance:
Posterior microphthalmos (PM) is a rare developmental disorder characterised by high hyperopia, short axial length, presence of retinal papillomacular fold and relatively normal anterior segment findings.
Background:
The purpose of the study was to compare the retinal arcade distance from fovea between PM cases and to correlate axial shortening in PM eyes with imaging findings.
Methods:
This retrospective, comparative case series included 24 eyes of 12 patients with PM as cases and an equal number of age- and sex-matched controls. Retinal findings on optical coherence tomography (OCT), OCT-angiography, Multicolour® image, axial length and corneal biometry were computed, compared and correlated between two groups.
Results:
Retinal papillomacular fold was noted in all 24 PM eyes. Retinal arcade narrowing was noted in PM (p < 0.001). The central retina (p < 0.001) and choroid (p = 0.003) was thick in PM. Corneal biometry showed shorter axial length (p < 0.001), high keratometry readings (p < 0.001) and small corneal diameters (p = 0.011) in PM. Vessel density (p = 0.031) on OCTA was denser and foveal avascular zone area (p = 0.033) reduced in PM. Strong negative correlation of axial length with spherical equivalent (r = > -0.804;p < 0.001), vessel density (r = > -0.803; p = <0.001) and K1 (r = > -0.76; p < 0.001) and K2 (r = > -0.67; p = 0.001) keratometry readings was noted in PM. Significant positive correlation was noted between axial length and anterior chamber depth (r = 0.75; p < 0.001), foveal avascular zone area (r = 0.56; p = 0.033) and corneal diameter (r = 0.65; p = 0.001). Vessel density on OCT-angiography correlated positively with central corneal thickness (r = 0.552;p = 0.005) and corneal powers K1 (r = 0.709; p = 0.001) and K2 (r = 0.56; p = 0.004) and negatively with corneal diameter (r = > -0.521; p = 0.033).
Conclusion:
Increased choroidal thickening and retinal vascular arcade narrowing were two important, interesting observations noted with PM. Intercorrelation between the axial length, OCT, OCT-angiography and corneal biometry helped in understanding the pathogenesis and the structural and vascular changes in PM eyes.
Insights
Posterior microphthalmos (PM) is a rare eye condition. This study found PM eyes have thickened choroids and narrowed retinal blood vessels, correlating with shorter axial lengths and specific corneal changes.
Area of Science:
- Ophthalmology
- Developmental Biology
- Medical Imaging
Background:
- Posterior microphthalmos (PM) is a rare developmental disorder characterized by high hyperopia and short axial length.
- Key features include retinal papillomacular folds and a relatively normal anterior segment.
- Understanding the structural and vascular changes in PM is crucial for diagnosis and management.
Purpose of the Study:
- To compare retinal arcade distance from the fovea in posterior microphthalmos (PM) cases versus controls.
- To correlate axial shortening in PM eyes with various imaging findings.
Main Methods:
- A retrospective comparative case series involving 24 eyes of 12 PM patients and 12 age/sex-matched controls.
- Utilized optical coherence tomography (OCT), OCT-angiography, and Multicolour® imaging.
- Analyzed axial length and corneal biometry, comparing findings between groups.
Main Results:
- All PM eyes exhibited retinal papillomacular folds and retinal arcade narrowing.
- PM eyes showed thickened central retina and choroid, shorter axial length, higher keratometry, and smaller corneal diameters.
- OCT-angiography revealed denser vessel density and a reduced foveal avascular zone area in PM.
Conclusions:
- Posterior microphthalmos is associated with significant choroidal thickening and retinal vascular arcade narrowing.
- Intercorrelation of axial length, OCT, OCT-angiography, and corneal biometry provides insights into the pathogenesis of PM.
- These findings aid in understanding the structural and vascular alterations in PM eyes.
