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Niazi S, Dhubhghaill SN, Doroodgar F, Gatzioufas Z, Dehghan MH. Insight into small eyes: a practical description from phenotypes presentations to the management. Int J Ophthalmol 2024; 17:380-391. [PMID: 38371260 PMCID: PMC10827624 DOI: 10.18240/ijo.2024.02.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 11/29/2023] [Indexed: 02/20/2024] Open
Abstract
This narrative review aimed to have an algorithmic approach to microphthalmos by a systematic search. The definition can be related to a number of special phenotypes. In the more challenging cases of complex microphthalmos, relative anterior microphthalmos, and nanophthalmos, the surgeon can approach these cases more safely if they have a deep understanding of the anatomical variations and ideal formulae for intraocular lens computation and knows how to avoid intra- and post-operative complications. In this article, we review the criteria by which we recognize and describe pre-, intra-, and post-operative considerations, as well as discuss the ideal intraocular lenses for microphthalmos, given the intricate varieties of small eye phenotypes.
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Affiliation(s)
- Sana Niazi
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran 1416753955, Iran
| | - Sorcha Ní Dhubhghaill
- Antwerp University Hospital, Edegem 2650, Belgium
- Faculty of Health Sciences, Antwerp University, Antwerpen 2000, Edegem, Belgium
| | - Farideh Doroodgar
- Translational Ophthalmology Research Center, Tehran University of Medical Sciences, Tehran 1416753955, Iran
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran 16666, Iran
| | | | - Mohammad Hossein Dehghan
- Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran 16666, Iran
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Fernández-Vigo JI, Gómez-de-Liaño CN, Rodríguez-Quet O, Burgos-Blasco B, Montolío-Marzo E, de-Pablo-Gómez-de-Liaño L, González-Martin-Moro J, García-Feijóo J. Clinical update in nanophthalmos: Features, diseases and complications associated. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:687-702. [PMID: 37813187 DOI: 10.1016/j.oftale.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/25/2023] [Indexed: 10/11/2023]
Abstract
Nanophthalmos is a rare congenital condition of the eyeball that is characterised by a smaller size of the anterior and posterior segments without associated ocular malformations. Typical features that have traditionally been described in these eyes are short axial length, thickened sclera, cornea with a smaller diameter, narrow anterior chamber, and an increased lens to globe volume ratio. However, at present, there is still a lack of recognised diagnostic criteria for nanophthalmos and a classification of its severity. Its clinical relevance stems from the increased risk of multiple ocular conditions, such as high hyperopia, amblyopia, angle-closure glaucoma, retinal detachment, and cataracts. Likewise, in relation to surgery in these eyes, there are particularities in cataract and glaucoma surgery and with a greater risk of associated intra- and postoperative complications. In this way, the treatment of nanophthalmos focuses on controlling the associated eye conditions and reducing and controlling surgical complications. This review aims to update what has been published in recent years regarding nanophthalmos.
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Affiliation(s)
- J I Fernández-Vigo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Madrid, Spain.
| | - C N Gómez-de-Liaño
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - O Rodríguez-Quet
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - B Burgos-Blasco
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - E Montolío-Marzo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | | | - J González-Martin-Moro
- Departamento de Oftalmología, Hospital Universitario del Henares, Coslada, Madrid, Spain
| | - J García-Feijóo
- Departamento de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
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Fernández-Vigo JI, Rodríguez-Quet O, Montolío-Marzo E, Burgos-Blasco B, Kudsieh B, González-Martin-Moro J, García-Feijóo J. Anterior Scleral Thickness and Other Dimensions in Nanophthalmos by Swept-Source Optical Coherence Tomography: A Comparative Study. J Clin Med 2023; 12:5564. [PMID: 37685634 PMCID: PMC10488421 DOI: 10.3390/jcm12175564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/14/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this study is to assess the ocular dimensions of the anterior and posterior segment, including the anterior scleral thickness (AST) in nanophthalmos compared to control eyes. METHODS A cross-sectional comparative study was carried out in two groups: 46 eyes of 28 patients with nanophthalmos, defined as axial length (AXL) < 20.5 mm, and 60 eyes of 30 controls paired by age and sex. The AST and ocular wall thickness (OWT) were measured by optical coherence tomography in the temporal and nasal quadrants at 1, 2, and 3 mm from the scleral spur. Also, the anterior chamber depth (ACD), white-to-white (WTW), lens thickness (LT), subfoveal choroidal thickness (SFCT), and retinal thickness (RT) were evaluated. RESULTS The mean AXL was 19.3 ± 1.5 mm in the nanophthalmos group and 23.9 ± 1.1 mm in the control group (p < 0.001). The OWT was thicker in all measurement points in nanophthalmos (p < 0.001). There were no differences in the AST measurements between groups, except for the AST1 and the AST3 in the nasal quadrant. ACD was shallower and LT was thicker in nanophthalmos, with WTW being larger in controls (p < 0.001). SFCT and RT were thicker in nanophthalmos compared to healthy individuals (p < 0.001). CONCLUSIONS Significant anatomical differences are found in nanophthalmic eyes. They present a shallower ACD; thicker LT, OWT, choroid, and retina; and smaller WTW diameter-although no relevant differences in the AST were observed.
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Affiliation(s)
- José Ignacio Fernández-Vigo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), 28040 Madrid, Spain; (O.R.-Q.); (E.M.-M.); (B.B.-B.); (J.G.-F.)
- Department of Ophthalmology, Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain;
| | - Olivia Rodríguez-Quet
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), 28040 Madrid, Spain; (O.R.-Q.); (E.M.-M.); (B.B.-B.); (J.G.-F.)
| | - Elena Montolío-Marzo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), 28040 Madrid, Spain; (O.R.-Q.); (E.M.-M.); (B.B.-B.); (J.G.-F.)
| | - Bárbara Burgos-Blasco
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), 28040 Madrid, Spain; (O.R.-Q.); (E.M.-M.); (B.B.-B.); (J.G.-F.)
| | - Bachar Kudsieh
- Department of Ophthalmology, Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain;
- Department of Ophthalmology, Hospital Puerta de Hierro-Majadahonda, 28220 Madrid, Spain
| | - Julio González-Martin-Moro
- Department of Ophthalmology, Hospital Universitario del Henares, 28822 Madrid, Spain;
- Faculty of Medicine, Universidad Francisco de Vitoria, 28223 Madrid, Spain
| | - Julián García-Feijóo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), 28040 Madrid, Spain; (O.R.-Q.); (E.M.-M.); (B.B.-B.); (J.G.-F.)
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Ren X, Gao Y, Lin Y, Fu X, Xiao L, Wang X, Zeng Z, Bao L, Yan N, Zhang M, Tang L. A Novel Mutation in the Membrane Frizzled-Related Protein Gene for Posterior Microphthalmia, Non-pigmented Retinitis Pigmentosa, Optic Nerve Drusen, and Retinoschisis in a Consanguineous Family. Front Med (Lausanne) 2022; 9:835621. [PMID: 35402469 PMCID: PMC8987310 DOI: 10.3389/fmed.2022.835621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Microphthalmos (MCO) is a rare developmental defect characterized by small malformed eyes. Our study aimed to describe the clinical characteristics of posterior microphthalmos syndrome caused by a novel variant in MFRP gene in a Chinese patient. Methods Complete ophthalmologic examinations were performed for the proband and proband's family members. Whole exon sequencing (WES) and Sanger sequencing were used to identify the mutated genes, and bioinformatic analysis was undertaken to predict the effect of this variant. Results Clinical analysis showed that the proband had reduced axial length (17.95 and 17.98 mm) with normal-size corneas and shallow anterior chamber depth. Fundus photography showed scattered yellowish-white spots in the whole retina with cup-to-disc ratios of 0.95 in both eyes. Retinoschisis in the inner nuclear layer and reduced outer retina thickness were apparent on OCT examination, and optic nerve drusen demonstrated increased autofluorescence in fundus autofluorescence (FAF). Perimeter examination revealed a tubular visual field for the right eye, and electroretinography (ERG) revealed a moderately reduced rod response combined with compromised cone response. Ocular examinations of the patient's family members were unremarkable. WES revealed that the proband had homozygous mutations in c.55-1 (IVS1) G>A in intron 1 for the MFRP gene. Both the proband's parents and offspring were confirmed to be heterozygous by Sanger sequencing. Bioinformatic analysis showed this mutation was deleterious. Conclusion We reported autosomal recessive posterior microphthalmia, atypical retinitis pigmentosa, and retinoschisis caused by a novel mutation in the MFRP gene in this consanguineous marriage family. Our study further broadens the mutation and phenotype spectrum of the MFRP gene in microphthalmia.
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Affiliation(s)
- Xiang Ren
- Ophthalmic Laboratory, Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yunxia Gao
- Ophthalmic Laboratory, Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Lin
- Ophthalmic Laboratory, Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Xiangyu Fu
- Ophthalmic Laboratory, Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Lirong Xiao
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoyue Wang
- Ophthalmic Laboratory, Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhibing Zeng
- Ophthalmic Laboratory, Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Li Bao
- Ophthalmic Laboratory, Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Naihong Yan
- Research Laboratory of Ophthalmology and Vision Sciences, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Ming Zhang
- Ophthalmic Laboratory, Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Ming Zhang
| | - Li Tang
- Ophthalmic Laboratory, Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
- Li Tang
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