Longitudinal follow-up of dome-shaped macula

Abstract

Background/objectives To determine if the presence of sub-retinal fluid (SRF) was associated with reduced vision in dome-shaped macula (DSM), and to assess its effect and response to treatment during follow-up. Methods Patients were identified retrospectively. Baseline and follow-up data were recorded. The diagnosis of DSM, and presence or absence of SRF and intra-retinal fluid (IRF) was confirmed using Spectral Domain-Optical Coherence Tomography (SD-OCT). Decisions to treat oedema were based on clinician preference. Results 193 eyes of 106 patients (71 female) were confirmed to have DSM. Overall mean duration of follow-up for this cohort was 3.5 years. Mean BRVA for all eyes at baseline was 0.38 (range: −0.20 to ‘light perception’). A significant difference was noted in mean baseline BRVA between those eyes with SRF compared with those without SRF at baseline (0.48 vs. 0.31, p < 0.001). Intra-retinal fluid moderately correlated with poorer baseline BRVA ( r = 0.31, p < 0.003). No significant change in BRVA was noted during follow-up. No significant effect of treatment on BRVA was observed. Conclusions The presence of SRF at baseline was associated with poorer vision. Vision appears to remain stable irrespective of the presence or absence of SRF at baseline. The treatments administered in this cohort did not affect final vision or SRF.

Evolution of Dome-shaped Macula Is Due to Differential Elongation of the Eye Predominant in the Peri-dome Region

“…4,5 In this study, we included five eyes with DSM smaller than 50 µm. As this limit has been proposed in many studies to consider the presence of DSM, 7, [11][12][13][14][15] one may argue that those eyes may have biased the results of the present work. Indeed, to exclude this possibility, we performed the statistical analysis after exclusion of those five eyes.…”

“…Considering that DSM has been previously reported in emmetropic and hyperopic eyes, 5 the emmetropic or hyperopic state and the absence of posterior staphyloma were not considered as exclusion criteria. In the literature, some studies have excluded DSM inferior to 50 µm, 7, [11][12][13][14][15] while some other did not. 1,[4][5][6]8 In the present work, the DSM height inferior to 50 µm was not an exclusion criterion.…”

“…6,7 However, it remains unknown whether smaller bulges demonstrate the same evolution, as most studies on the subject only reported DSM with bulges far greater than 100 µm high. 7, [11][12][13][14][15] The main objective of this study was to determine if the increase in DSM height was due to an inward evolution of the bulge or to an outwardly-oriented expansion of the peri-macular regions. To determine this, changes in axial length (AL) and height of the macular bulge were retrospectively studied in a cohort of DSM patients, also including patients presenting with particularly small DSM.…”

IMI Pathologic Myopia

“…225 The fluid resolution may also correspond with the development of RPE and outer retina atrophy in the macula. 219 Most studies of SRF associated with dome-shaped macula have shown a poorer visual acuity at baseline or during the follow-up 219,226 but in one study, a similar prognosis has been reported between eyes with and without SRF after a 2-year follow-up. 227 Other reported complications include pigment epithelial detachment at the dome apex, 228 polypoidal choroidal vasculopathy, 229 and MNV that is more easily detected on OCTA.…”

Spectral-Domain Optical Coherence Tomography-Based Morphofunctional Characterization of Dome-Shaped Maculopathy in Indian Population

“…Although the prevalence of DSM has not been reported by any population-based study, incidence of DSM in highly myopic eyes has been estimated as 20% in Japan [13], 16% in Turkey [14], and 11% in Europe [15]. DSM has been documented in adults, adolescents, and children in many other parts of the world, namely, Canada [11], USA [16,17], UK [18,19], Europe [10,15,20,21], Korea [22,23], and Japan [16,24]. Although, DSM was initially believed to occur exclusively in high myopic eyes with staphyloma, it has also been described in emmetropes, hypermetropes [18], and eyes without staphyloma [16].…”