Unique Foveal Contour Changes in Series of Children With Hyperopia
Narrative Responses:
Purpose
To describe specific changes in macula configuration in a series of children with hypermetropia with or without strabismus
Methods
Retrospective case series of 6 children with significant hypermetropia who were identified with similar atypical features of fovea in both eyes. A complete ophthalmological examination was done, macula OCT was performed by spectral- domain OCT (Cirrus HD, Carl Zeiss). The main outcome measures were central foveal thickness, distance between nasal and temporal foveal edges and perifoveal thickness in 8 surrounding locations. The measurements were compared with 20 age-matched control children.
Results
The mean age of the patient group was 6.9±1.2 years and the control group 8.4 ±2.6 years. Mean spherical equivalent was + 5.7±2.0 D (range + 4.00- +8.00D) in the patient group. Three patients had accommodative esotropia. Fundus examination revealed clinical appearance of foveal thinning and tiny subfoveal yellow deposits. Macula OCT displayed loss of normal V-shaped foveal contours with widened and flattened pit contours, decrease in central foveal thickness and increase in distance between foveal edges. Central foveal thickness was significantly less in left eyes (p= 0.01 ), the distance within foveal edges was significantly increased in right eyes (p=0.001).
Conclusion
This is the first report of this type of change in foveal contour shape in high hypermetropia. This macular structure seem to be a unique disorder where the clinical characteristics are distinctly different from the lamellar holes or macular pseudo holes.