Clinical Ophthalmology (Aug 2020)
Ocular Manifestations and Biometrics in Marfan’s Syndrome from Eastern Nepal
Abstract
Rinkal Suwal,1 Simanta Khadka,2 Purushottam Joshi3 1Department of Optometry, BP Eye Foundation, Hospital for Children, Eye, ENT and Rehabilitation Service (CHEERS), Bhaktapur, Nepal; 2Department of Vitreo-Retina, Bharatpur Eye Hospital, Bharatpur, Chitwan, Nepal; 3Department of Vitreo-Retina, Mechi Eye Hospital, Birtamod, Jhapa, NepalCorrespondence: Simanta KhadkaDepartment of Vitreo-Retina, Bharatpur Eye Hospital, Bharatpur, Chitwan, NepalTel +977-9841572286Fax +977-056-523333Email [email protected]: To evaluate the ocular characteristics of Marfan’s syndrome (MFS) fulfilling the revised Ghent-2 nosology in Eastern Nepal.Materials and Methods: A hospital-based observational and cross-sectional study was conducted. Ocular manifestations and biometrics were incorporated. Patients were subdivided into adults (16 years or older) and children (5– 15 years). Ocular biometric parameters consisted of values of refractive error, keratometry readings, anterior chamber depth (ACD), central corneal thickness (CCT), lens thickness (LT) and axial length (AL).Results: A total of 34 eyes of 17 patients with MFS were included, where 32 eyes were phakic. Mean age of the study participants was 14.5 ± 9.1 years. The mean best corrected visual acuity (BCVA) of phakic eyes was 0.99 ± 0.82 LogMAR. Myopia greater than − 3 diopters (D) was present in 28/34 (82.35%) eyes. The average spherical equivalent was − 12.34 ± 8.85 D. Ectopia lentis (EL) was present in 24/32 (75%) eyes where superonasal was the most common subluxation in 10/24 (41.7%) eyes. AL was longer in adults 26.54 ± 4.42 mm compared to 25.21 ± 1.93 mm in children. Likewise, LT in adults was 4.9 ± 0.70 mm and 4.40 ± 0.59 mm in pediatric participants. Flat corneas were noted in both the groups with an average of 41.53 ± 2.21 D. The mean CCT and ACD were 524.62 ± 21.74 μm and 3.64 ± 0.80 mm, respectively. There was a negative association between the AL and the average corneal curvature (Kmed, correlation coefficient − 0.11, p=0.54).Conclusion: Myopia is the foremost ocular involvement with significant visual disability in MFS. Though, AL and corneal curvature are not included in the revised Ghent-2 nosology, we strongly recommend these parameters to be considered during ophthalmic evaluation in suspected and diagnosed cases of MFS in the absence of genetic testing.Keywords: corneal astigmatism, ectopia lentis, flattened cornea, Marfan’s syndrome, ocular biometry
