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The extended clinical phenotype of dome-shaped macula

  • Medical Ophthalmology
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To describe the phenotype, associations, and complications of dome-shaped macula (DSM) through the combination of spectral-domain optical coherence tomography (OCT) imaging and B-scan ultrasonography, when available. This retroprospective cohort study aims to gain further pathophysiological understanding in eyes with DSM.

Methods

Fifty-eight eyes of 36 patients were identified as having OCT features of DSM. Retinal and choroidal thicknesses were determined from enhanced depth imaging (EDI)-OCT image sets, with scleral thickness subsequently calculated by subtraction from the B-scan ultrasound-derived measurements of posterior coat thickness.

Results

DSM was associated with myopia in 81 % of eyes. The underlying clinical diagnosis was variable: central serous chorioretinopathy (CSCR)-like entity, choroidal neovascularization, and inherited retinal disorders. The subfoveal choroidal thickness of the nine highly myopic eyes with a CSCR-like phenotype was thicker than the 25 eyes without CSCR (p = 0.169). The mean subfoveal scleral thickness of the highly myopic eyes was 585 ± 196 μm, which was significantly different from those with a refractive error less than 6 diopters (1133 ± 290 μm) (P < 0.0001).

Conclusions

This study highlights the novel observation of a thickened choroid when CSCR is present. In addition, we expand the associations of DSM to eyes with hypermetropia and acquired disease, and to those with inherited retinal dystrophies.

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Abbreviations

DSM:

dome-shaped macula

OCT:

optical coherence tomography

EDI:

enhanced depth imaging

VA:

visual acuity

CSCR:

central serous chorioretinopathy

CNV:

choroidal neovascularization

RPE:

retinal pigment epithelium

FA:

fluorescein angiography

ICGA:

indocyanine green angiography

D:

diopters

SD:

standard deviation

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Conflicts of interest

The authors have no proprietary interests in the material presented.

Drs. Keane, Egan, Tufail, and Patel have received a proportion of their funding from the Department of Health’s NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital, and UCL Institute of Ophthalmology. The views expressed in the publication are those of the author and not necessarily those of the Department of Health.

Dr. Tufail has been on advisory boards for Novartis, Pfizer, GSK, Thrombogenics, Bayer and Allergan. Drs. Keane and Patel have received travel grants from the Allergan European Retina Panel. Dr. Patel has been on advisory boards for Novartis UK. Dr. Michaelides is supported by a Foundation Fighting Blindness Career Development Award.

Dr Marie-Hélène Errera has received a travel grant from Novartis France.

Dr Marie-Hélène Errera wants to thank Dr Pablo Goldschmidt, Centre Hospitalier des Quinze-Vingts, for helpful discussion in statistics.

Clinical trial registration number ERRM1003 (Moorfields Eye Hospital, London, UK)

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Authors and Affiliations

  1. NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK

    Marie-Hélène Errera, Michel Michaelides, Pearse A. Keane, Marie Restori, Anthony T. Moore, Jonathan Yeoh, Derek Chan, Catherine A. Egan, Praveen J. Patel & Adnan Tufail

  2. Ophthalmology Department IV, Centre Hospitalier National des Quinze-Vingts, UPMC Univ Paris 06, 28 rue de Charenton, 75012, Paris, France

    Marie-Hélène Errera & Michel Paques

Authors
  1. Marie-Hélène Errera
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  2. Michel Michaelides
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  3. Pearse A. Keane
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  4. Marie Restori
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  5. Michel Paques
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  6. Anthony T. Moore
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  7. Jonathan Yeoh
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  8. Derek Chan
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  9. Catherine A. Egan
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  10. Praveen J. Patel
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  11. Adnan Tufail
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Corresponding author

Correspondence to Marie-Hélène Errera.

Additional information

Presented as a poster at the Association for Research in Vision and Ophthalmology Meeting Seattle, May 2013

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Errera, MH., Michaelides, M., Keane, P.A. et al. The extended clinical phenotype of dome-shaped macula. Graefes Arch Clin Exp Ophthalmol 252, 499–508 (2014). https://doi.org/10.1007/s00417-013-2561-7

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  • DOI: https://doi.org/10.1007/s00417-013-2561-7

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