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A. Hong, L. Spielberg, S. Rao, J. Panarelli, K. Mukkamala, G. Landa, R. Rosen, A. Ponce; Bilateral Papillomacular Folds in Nanophthalmos: Advanced Retinal Imaging. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4385.
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© ARVO (1962-2015); The Authors (2016-present)
To report the results of the retinal imaging of a rare case of bilateral partial-thickness papillomacular retinal folds in pediatric nanophthalmos.
A patient referred for nanophthalmos underwent advanced retinal imaging, including fundus exam, color fundus photography (CFP), scanning laser ophthalmoscopy and spectral-domain optical coherence tomography (SLO/OCT), non-contrast angiography (NCA), autofluorescence (AF) and perimacular retinal blood flow (RBF) velocity using the retinal functional imager (RFI).
Imaging report of a 9-year-old female with axial lengths of 18.2mm OD and 18.3mm OS, best-corrected visual acuity (VA) of 20/30 OD and 20/50 OS and refractive error of +14 OD and +15 OS. Fundus exam revealed bilateral papillomacular retinal folds and absent foveal light reflexes. CFP showed crowded optic discs and a normal macular pigment distribution. SLO/OCT revealed bilateral partial-thickness retinal folds and bilateral absence of the foveal depression. NCA showed a rudimentary foveal avascular zone (FAZ) OS and an unusually small FAZ OD. AF and RBF velocity were normal bilaterally.
This is the first report of comprehensive imaging of bilateral papillomacular retinal folds in nanophthalmos. OCT revealed that the retinal folds are in fact partial-thickness and exclude the inner segment/outer segment junction. NCA confirmed previous reports of a rudimentary FAZ in nanophthalmos that, along with an absent foveal depression, may be the main limitation to obtaining an optimal VA. In contrast to previous reports, the macula is not hyperpigmented. This report also highlights the utility of NCA in unusual situations in which the patient is unable to get FA due to fear of allergic complications.
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