Mihara Miharu, Hayashi Atsushi, Oiwake Toshihiko
Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan.
Am J Ophthalmol Case Rep. 2019 Nov 7;16:100568. doi: 10.1016/j.ajoc.2019.100568. eCollection 2019 Dec.
We report the case of an 11-year-old boy with posterior microphthalmos who exhibited normal and age appropriate development of visual acuity.
At the initial diagnosis, when he was 3 years old, the best-corrected visual acuity (BCVA) was 20/125 in the right eye (OD) and 20/200 in the left eye (OS) with high hyperopia (cycloplegic refraction +15.75 D sphere OD and +16.25 D sphere OS). Eight years after he began wearing hyperopic glasses, BCVA was 20/16 OD and 20/20 OS. Optical coherence tomography did not reveal a foveal pit in either eye throughout the observation period. However, elongation of the outer segment and widening of the outer nuclear layers were observed.
Many cases of posterior microphthalmos demonstrate subnormal BCVA due to an abnormal foveal structure (papillomacular retinal folds, absence of the foveal pit and avascular zone) and high hyperopia. However, if foveal maturity progresses, even if the foveal structure is abnormal, early aggressive amblyopia treatment can result in normal and age appropriate development of visual acuity.
我们报告一例11岁患有后部小眼球的男孩病例，其视力发育正常且与年龄相符。
在3岁初诊时，右眼（OD）最佳矫正视力（BCVA）为20/125，左眼（OS）为20/200，伴有高度远视（睫状肌麻痹验光OD为+15.75 D球镜，OS为+16.25 D球镜）。开始佩戴远视眼镜8年后，BCVA为OD 20/16，OS 20/20。在整个观察期内，光学相干断层扫描未发现任何一只眼睛有中央凹坑。然而，观察到外段伸长和外核层增宽。
许多后部小眼球病例由于中央凹结构异常（视乳头黄斑视网膜皱褶、中央凹坑和无血管区缺失）和高度远视，表现出低于正常的BCVA。然而，如果中央凹成熟进展，即使中央凹结构异常，早期积极的弱视治疗也可导致视力正常且与年龄相符的发育。
