Pardo-López Diamar, Gallego-Pinazo Roberto, Mateo Carlos, Rohrweck Stephanie, Suelves Ana M, Dolz-Marco Rosa, Mullor José Luis, Díaz-Llopis Manuel
Department of Ophthalmology, University and Polytechnic Hospital La Fe, Barcelona, Spain.
Case Rep Ophthalmol. 2011 Jan;2(1):111-5. doi: 10.1159/000326918. Epub 2011 Mar 16.
An entirely new type of staphyloma has been recently described as dome-shaped macula (DSM). It is characterized by an abnormal convex macular contour within the concavity of a posterior staphyloma. We found DSM associated with serous macular detachment (SMD) and tilted disc in two consecutive cases.
Case 1: A 37-year-old female presented to our department because of sudden onset blurred vision in her right eye (OD). The best-corrected visual acuity (BCVA) was 0.5 in both eyes. Funduscopy evidenced bilateral tilted disc associated with posterior staphyloma. Optical coherence tomography (OCT) demonstrated a DSM with SMD in her OD. After 15 months of follow-up, BCVA of her OD remained stable with chronic SMD. Case 2: A 32-year-old female presented to our department because of blurred vision in her OD. The BCVA was 0.4 in the OD and 1.0 in the left eye (OS). Bilateral tilted disc and posterior staphyloma were evidenced in the funduscopy. OCT demonstrated a bilateral DSM with SMD in her OD. After 45 months of follow-up, two further episodes of transient SMD were observed in her OD and seven in her OS. The final BCVA was 0.63 in the OD and 0.8 in the OS.
SMD associated with tilted disc constitutes a potential cause of subretinal fluid accumulation in myopic patients. OCT is essential for the detection of both SMD and DSM.
最近一种全新类型的葡萄肿被描述为穹窿状黄斑（DSM）。其特征是在后葡萄肿凹陷内黄斑轮廓异常凸起。我们在连续两例病例中发现DSM与浆液性黄斑脱离（SMD）和倾斜视盘相关。
病例1：一名37岁女性因右眼突然视力模糊就诊于我科。双眼最佳矫正视力（BCVA）均为0.5。眼底检查发现双侧倾斜视盘伴后葡萄肿。光学相干断层扫描（OCT）显示其右眼存在伴有SMD的DSM。随访15个月后，其右眼BCVA随慢性SMD保持稳定。病例2：一名32岁女性因右眼视力模糊就诊于我科。右眼BCVA为0.4，左眼（OS）为1.0。眼底检查发现双侧倾斜视盘和后葡萄肿。OCT显示其右眼存在双侧伴有SMD的DSM。随访45个月后，观察到其右眼又出现了两次短暂性SMD，左眼出现了七次。最终右眼BCVA为0.63，左眼为0.8。
与倾斜视盘相关的SMD是近视患者视网膜下液体积聚的一个潜在原因。OCT对于检测SMD和DSM至关重要。
