Service d'Ophtalmologie, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Université Paris Diderot, Paris, France.
Am J Ophthalmol. 2013 Nov;156(5):958-967.e1. doi: 10.1016/j.ajo.2013.06.032. Epub 2013 Aug 20.
To analyze dome-shaped maculas topographic features and related serous retinal detachment (SRD) in eyes with myopic staphyloma.
Retrospective, observational case series.
We reviewed the records of 48 eyes in 33 patients with dome-shaped maculas who were referred because of decreased vision. Ophthalmologic examination included axial length measurement, spectral domain optical coherence tomography (OCT), and fluorescein and indocyanine green angiography. The height of the macular bulge was measured, and the choroidal thickness was mapped.
Patient mean age was 55.0 ± 13.6 years. Mean axial length was 27.49 ± 2.53 mm. Mean best-corrected visual acuity (BCVA) was 0.50 ± 0.33 logMAR. Three dome-shaped macula patterns were observed: round dome in 10/48 (20.8%) eyes; horizontal oval-shaped dome in 30/48 (62.5%) eyes; and vertical oval-shaped dome in 8/48 (16.7%) eyes. The mean macular bulge height was 407.7 ± 215.1 μm (120-1130) and was significantly greater in vertical oval-shaped domes. The mean central choroidal thickness (CCT) was 146.5 ± 56.0 μm, significantly greater than at 3 mm nasal and temporal to the fovea (P < 0.0001). The CCT was positively correlated to macular bulge height but not to BCVA. Foveal SRD was present in 25/48 eyes and significantly increased for macular bulge height greater than 350 μm (P = 0.0047). BCVA was significantly lower when SRD was present (P = 0.043).
Most dome-shaped maculas did not display a round but a horizontal or vertical oval-shaped dome and could be missed on a single OCT scan. Chronic foveal SRD was associated with decreased vision and was more common when the macular bulge was highly elevated.
分析近视性葡萄肿眼的盘状黄斑的地形特征及其相关的浆液性视网膜脱离（SRD）。
回顾性、观察性病例系列。
我们回顾了 33 例 48 只因视力下降而就诊的盘状黄斑患者的病历。眼科检查包括眼轴长度测量、谱域光学相干断层扫描（OCT）以及荧光素和吲哚青绿血管造影。测量黄斑隆凸的高度，并绘制脉络膜厚度图。
患者平均年龄为 55.0 ± 13.6 岁。平均眼轴长度为 27.49 ± 2.53mm。平均最佳矫正视力（BCVA）为 0.50 ± 0.33 logMAR。观察到三种盘状黄斑形态：圆形盘状 10/48（20.8%）只眼；水平椭圆形盘状 30/48（62.5%）只眼；垂直椭圆形盘状 8/48（16.7%）只眼。黄斑隆凸高度的平均值为 407.7 ± 215.1μm（120-1130），垂直椭圆形盘状的黄斑隆凸高度明显更大。中央脉络膜厚度（CCT）的平均值为 146.5 ± 56.0μm，显著大于黄斑中心凹鼻侧和颞侧 3mm（P<0.0001）。CCT 与黄斑隆凸高度呈正相关，但与 BCVA 无关。25/48 只眼存在黄斑中心凹 SRD，当黄斑隆凸高度大于 350μm 时，SRD 显著增加（P=0.0047）。当存在 SRD 时，BCVA 显著降低（P=0.043）。
大多数盘状黄斑并非呈现圆形，而是呈现水平或垂直椭圆形，在单次 OCT 扫描中可能会被忽略。慢性黄斑中心凹 SRD 与视力下降有关，当黄斑隆凸高度显著升高时更为常见。
