Abstract
First described by Gaucher and associates in 2008 in eyes with high myopia, dome-shaped maculopathy (DSM) is an anterior convex protrusion of the macula towards the vitreous cavity observable on OCT. This seems to be related to a localized scleral thickness, which might be the result of regional variation in the scleral bio-mechanical properties and the process of emmetropization causing asymmetric scleral growth. The presence of DSM can be associated with an increased risk of complications. The clinical spectrum ranges from being asymptomatic to metamorphopsia and mild-to-moderate gradual visual loss over years. Visual impairment in DSM results from retinal pigment epithelial changes, sub-foveal serous detachment, retinoschisis and myopic choroidal neovascularization. In this review, we compile and review the available information on the pathophysiology, nomenclature, classification, clinical features including imaging, differential diagnosis, complications associated with DSM and the gaps in our understanding of this entity thus far.
摘要
拱形黄斑病变 (DSM) 由Gaucher及其同事于2008年首次在高度近视患者中发现, OCT可观察到黄斑部向玻璃体腔向前突出。这种凸出与局部巩膜厚度有关, 可能是由于局部巩膜生物力学特性的变化和正视化过程导致巩膜不对称生长的结果。DSM的发生可能与并发症的风险增加有关。临床表现在数年内可从无症状到视物变形、从轻度到中度渐进性视力丧失。DSM的视力损害由视网膜色素上皮改变、中央凹下浆液性脱离、视网膜劈裂和近视脉络膜新生血管引起。在这篇综述中, 我们回顾和整理了与DSM相关的可用信息, 包括病理生理学、命名、分类、临床特征(影像学、鉴别诊断、并发症)以及迄今为止对该病变的认知差距。
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References
Cheng CY, Wang N, Wong TY, Congdon N, He M, Wang YX, et al. Prevalence and causes of vision loss in East Asia in 2015: magnitude, temporal trends and projections. Br J Ophthalmol. 2020;104:616–22.
Morgan IG, French AN, Ashby RS, Guo X, Ding X, He M, et al. The epidemics of myopia: aetiology and prevention. Prog Retin Eye Res. 2018;62:134–49.
Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123:1036–42.
Ohno-Matsui K. Pathologic myopia. Asia-Pac J Ophthalmol. 2016;5:415–23.
Ng DS, Cheung CY, Luk FO, Mohamed S, Brelen ME, Yam JC, et al. Advances of optical coherence tomography in myopia and pathologic myopia. Eye. 2016;30:901–16.
Gaucher D, Erginay A, Lecleire-Collet A, Haouchine B, Puech M, Cohen SY. et al. Dome-shaped macula in eyes with myopic posterior staphyloma. Am J Ophthalmol. 2008;145:909–14.
Curtin BJ. The posterior staphyloma of pathologic myopia. Ann Ophthalmol. 1977;75:67
Ohsugi H, Ikuno Y, Oshima K, Yamauchi T, Tabuchi H. Morphologic characteristics of macular complications of a dome-shaped macula determined by swept-source optical coherence tomography. Am J Ophthalmol. 2014;158:162–70.
Ellabban AA, Tsujikawa A, Matsumoto A, Yamashiro K, Oishi A, Ooto S, et al. Three-dimensional tomographic features of dome-shaped macula by swept-source optical coherence tomography. Am J Ophthalmol. 2013;155:320–8.
Mehdizadeh M, Nowroozzadeh MH. Dome-shaped macula in eyes with myopic posterior staphyloma. Am J Ophthalmol. 2008;146:478.
Imamura Y, Iida T, Maruko I, Zweifel SA, Spaide RF. Enhanced depth imaging optical coherence tomography of the sclera in dome-shaped macula. Am J Ophthalmol. 2011;151:297–302.
Ellabban AA, Tsujikawa A, Muraoka Y, Yamashiro K, Oishi A, Ooto S, et al. Dome-shaped macular configuration: longitudinal changes in the sclera and choroid by swept-source optical coherence tomography over two years. Am J Ophthalmol. 2014;158:1062–70.
Chebil A, Ben BA, Chaker N, Jedidi L, Mghaieth F, El LM. Choroidal thickness assessment with SD-OCT in high myopia with dome-shaped macula. J Fr Ophtalmol. 2014;37:237–41.
Liang IC, Shimada N, Tanaka Y, Nagaoka N, Moriyama M, Yoshida T, et al. Comparison of clinical features in highly myopic eyes with and without a dome-shaped macula. Ophthalmology. 2015;122:1591–600.
Morgan IG, Ohno-Matsui K, Saw SM. Myopia. Lancet. 2012;379:1739–48.
Dennis YT, To CH. Graded competing regional myopic and hyperopic defocus produce summated emmetropization set points in chick. Invest Ophthalmol Vis Sci. 2011;52:8056–62.
Fang Y, Jonas JB, Yokoi T, Cao K, Shinohara K, Ohno-Matsui K. Macular Bruch’s membrane defect and dome-shaped macula in high myopia. PLoS ONE. 2017;12:e0178998.
Zhao X, Ding X, Lyu C, Li S, Lian Y, Chen X, et al. Observational study of clinical characteristics of dome-shaped macula in Chinese Han with high myopia at Zhongshan Ophthalmic Centre. BMJ Open. 2018;8:e021887.
Fang D, Zhang Z, Wei Y, Wang L, Zhang T, Jiang X, et al. The morphological relationship between dome-shaped macula and myopic retinoschisis: a cross-sectional study of 409 highly myopic eyes. Invest Ophthalmol Vis Sci. 2020;61:19.
Soudier G, Gaudric A, Gualino V, Massin P, Nardin M, Tadayoni R, et al. Long-term evolution of dome-shaped macula: increased macular bulge is associated with extended macular atrophy. Retina. 2016;36:944–52.
Sánchez JF, Ramos CC, Fernández JR, Segura JU. Clinical, fundoscopic, tomographic and angiographic characteristics of dome shaped macula classified by bulge height. Arch Soc Esp Oftalmol. 2017;92:458–63.
Hocaoglu M, Ersoz MG, Muslubas IS, Arf S, Karacorlu M. Factors associated with macular complications in highly myopic eyes with dome-shaped macular configuration. Graefes Arch Clin Exp Ophthalmol. 2019;257:2357–65.
Christenbury JG, Phasukkijwatana N, Tan A, Freund KB, Sarraf D. Dome-shaped maculopathy: enhanced visualization with radial optical coherence tomography scans. Retin Cases Brief Rep. 2017;11:S94–7.
Coco RM, Sanabria MR, Alegría J. Pathology associated with optical coherence tomography macular bending due to either dome-shaped macula or inferior staphyloma in myopic patients. Ophthalmologica. 2012;228:7–12.
Soudier G, Gaudric A, Gualino V, Massin P, Nardin M, Tadayoni R, et al. Macular choroidal thickness in myopic eyes with and without a dome-shaped macula: a case-control study. Ophthalmologica. 2016;236:148–53.
Viola F, Dell’Arti L, Benatti E, Invernizzi A, Mapelli C, Ferrari F, et al. Choroidal findings in dome-shaped macula in highly myopic eyes: a longitudinal study. Am J Ophthalmol. 2015;159:44–52.
Gallego-Pinazo R, Dolz-Marco R, Gómez-Ulla F, Mrejen S, Freund KB. Pachychoroid diseases of the macula. Med Hypothesis Disco Innov Ophthalmol. 2014;3:111.
Deobhakta A, Ross AH, Helal J, Maia A, Freund KB. Localized choroidal thickness variation and pigment epithelial detachment in dome-shaped macula with subretinal fluid. Ophthalmic Surg Lasers Imaging Retina. 2015;46:391–2.
Cicinelli MV, Pierro L, Gagliardi M, Bandello F. Optical coherence tomography and pathological myopia: an update of the literature. Int Ophthalmol. 2015;35:897–902.
Mateo C, Burés-Jelstrup A. Macular buckling with ando plombe may increase choroidal thickness and mimic serous retinal detachment seen in the tilted disk syndrome. Retin Cases Brief Rep. 2016;10:327–30.
García-Ben A, Sanchez MJ, Gómez AG, García-Basterra I, García AS, García-Campos JM. Factors associated with serous retinal detachment in highly myopic eyes with vertical oval-shaped dome. Retina. 2019;39:587–93.
García-Ben A, Garcia-Basterra I, González-Gómez A, Baquero-Aranda I, Morillo-Sanchez MJ, Soler-García A, et al. Comparison of long-term clinical evolution in highly myopic eyes with vertical oval-shaped dome with or without untreated serous retinal detachment. Br J Ophthalmol. 2019;103:385–9.
Alakeely AG, Alrashaed S. Serous retinal detachment in dome-shaped macula with 7 years follow-up. Middle East Afr J Ophthalmol. 2016;23:323–5.
Spaide RF, Goldbaum M, Wong DW, et al. Serous detachment of the retina. Retina. 2003;23:820–46.
Mitzy TS, Jesica D, Maximiliano G. Dome-shaped macula and foveal neurosensory retinal detachment—a case series. Open J Ophthalmol. 2019;9:151–60.
Chinskey ND, Johnson MW. Treatment of subretinal fluid associated with dome-shaped macula. Ophthalmic Surg Lasers Imaging Retina. 2013;44:593–5.
Fernández-Vega Sanz Á, Rangel CM, Villota Deleu E, Fernández-Vega Sanz B, Sánchez-Ávila RM. Serous retinal detachment associated with dome-shaped macula and staphyloma edge in myopic patients before and after treatment with spironolactone. J Ophthalmol. 2016;2016:8491320.
Soubrane G, Aknin I, Massamba N, Herpe CM. Dome-shaped macula detachment: new treatment approach in 2 cases. Invest Ophthalmol Vis Sci. 2014;55:5945.
Arapi I, Neri P, Mariotti C, Gesuita R, Pirani V, Freddo F, et al. Considering photodynamic therapy as a therapeutic modality in selected cases of dome-shaped macula complicated by foveal serous retinal detachment. Ophthalmic Surg Lasers Imaging Retina. 2015;46:217–23.
Dirani A, Matet A, Beydoun T, Mantel I, Behar-Cohen F. Resolution of foveal detachment in dome-shaped macula after treatment by spironolactone: report of two cases and mini-review of the literature. Clin Ophthalmol. 2014;8:999.
Chen NN, Chen CL, Lai CH. Resolution of unilateral dome-shaped macula with serous detachment after treatment of topical carbonic anhydrase inhibitors. Ophthalmic Surg Lasers Imaging Retina. 2019;50:e218–21.
Parodi MB, Iacono P, Bandello F. Subthreshold laser treatment for serous retinal detachment in dome-shaped macula associated with pathologic myopia. Retina. 2018;38:359–63.
Ceklic L, Wolf-Schnurrbusch U, Gekkieva M, Wolf S. Visual acuity outcome in RADIANCE study patients with dome-shaped macular features. Ophthalmology. 2014;121:2288–9.
Lee JH, Lee SC, Choi S, Koh HJ, Kim SS, Lee CS. Two-year outcomes of intravitreal bevacizumab for choroidal neovascularization associated with a dome-shaped macula in pathologic myopia. Eye. 2017;31:507–8.
Cai B, Yang J, Li S, Wang L, Chen L, Li X, et al. Comparison of the efficacy of intravitreal ranibizumab for choroidal neovascularization due to pathological myopia with and without a dome-shaped macula. Medicine. 2017;96:e9251.
Naysan J, Dansingani KK, Balaratnasingam C, Freund KB. Type 1 neovascularization with polypoidal lesions complicating dome shaped macula. Int J Retin Vitreous. 2015;1:8.
Iyer PG, Say EA, Shields CL. Dome-shaped macula simulating choroidal hemangioma in a myopic patient. Oman J Ophthalmol. 2015;8:188–90.
Xu X, Fang Y, Jonas JB, Du R, Shinohara K, Tanaka N, et al. Ridge-shaped macula in young myopic patients and its differentiation from typical dome-shaped macula in elderly myopic patients. Retina 2020;40:225–32.
Acknowledgements
We would like to acknowledge Miss Priya Jena to help us in collecting the OCT and fundus images used in the manuscript. We would also like to thank Dr Subhadra Jalali, Director & Head of Department of Vitreo-Retinal Services at L V Prasad Eye Hospital, India for her constant support and guidance.
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MJ, TRP and LG conceived and designed the review. MJ was involved in literature search and manuscript writing. TRP and LG were involved in critical review. LG was fundamental in overall supervision and feedback. All authors were critical in manuscript writing and improvement of present work
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Jain, M., Gopal, L. & Padhi, T.R. Dome-shaped maculopathy: a review. Eye 35, 2458–2467 (2021). https://doi.org/10.1038/s41433-021-01518-w
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DOI: https://doi.org/10.1038/s41433-021-01518-w
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