Presenting features, management, and long‐term visual outcome of nanophthalmos patients in King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia

Abstract

PurposeThe purpose of this study was to describe the presenting features of patients with nanophthalmos who presented to King Khaled Eye Specialist tertiary Hospital and their subsequent management.MethodsWe conducted a retrospective case series of nanophthalmos patients who presented to our institute from 1984 to 2019. Baseline features, including presenting symptoms, best‐corrected visual acuity (BCVA), intraocular pressure (IOP), associated clinical features, axial length, and refraction, were documented. Complications from the condition itself and as a result of surgery were also documented. The main outcome measures were the number of eyes that deteriorated by two lines or more and IOP at final follow‐up.ResultsIn total, there were 19 patients with bilateral nanophthalmos (38 eyes), 8 were males (42%), and 11 were females (57.9%), with a mean age of 38.8 ± 16 years (range 8‐61 years). The mean follow‐up was 10 ± 16 years (range 1–32 years). The mean ± SD IOP at presentation was 20.3 ± 7.4 mmHg (range 10–45 mmHg). Fourteen eyes had BCVA 20/20‐20/100 (36.8%), 12 had BCVA 20/125‐20/400 (31.5%), and 12 eyes had BCVA of worse than 20/400 (31.5%). The mean axial length was 16.5 ± 1.6 mm (range 14.1–20.0 mm). Over the course of follow‐up, 14 eyes had deteriorated by two or more lines (36.8%), while the majority (24 eyes) remained the same or improved (63.2%). Final IOP was within the normal range (5‐21 mmHg) in 29 eyes (76.3%), while nine eyes had IOP more than 21 mmHg (23.7%).ConclusionsMore than a third (36.8%) of eyes lost two or more lines of visual acuity by the last follow‐up, with a quarter of eyes having IOP >21 mmHg. The present study represents the largest study with long‐term follow‐up and end visual outcome of patients with nanophthalmos in Saudi Arabia.