Soudier Guillaume, Gaudric Alain, Gualino Vincent, Massin Pascale, Nardin Mathieu, Tadayoni Ramin, Speeg-Schatz Claude, Gaucher David
*Nouvel hôpital civil, University hospital of Strasbourg, France; †Bacteriological Laboratory (EA-7290), Federation Medicine, Translational of Strasbourg, University of Strasbourg, France; and ‡University hospital of Lariboisière, University Paris, France.
Retina. 2016 May;36(5):944-52. doi: 10.1097/IAE.0000000000000806.
Dome-shaped macula (DSM) may cause impaired vision. This study analyzed the long-term evolution of DSM, most particularly macular changes: serous retinal detachment, retinal pigment epithelium atrophy, and DSM bulge increase.
Twenty-nine eyes presenting with DSM were retrospectively studied. Clinical data, color photographs, fluorescein angiographs, and optical coherence tomography examinations were reviewed. Patients were followed up from 6 months to 111 months (mean, 37.89 months). The height of the macular bulge, the size of retinal pigment epithelium macular atrophy, and serous retinal detachment progression were studied. Other macular changes were noted.
Mean vision remained stable. Dome-shaped macula height increased significantly from 338.9 μm to 364.3 μm (P = 0.007). Serous retinal detachment was present initially in 15 of 29 eyes; it increased in 4 cases and resolved spontaneously in 7. Macular retinal pigment epithelium atrophy correlated with the bulge height (P = 0.015), and it enlarged during follow-up (1.12 vs. 1.34, P = 0.04). Other macular anomalies were present initially or appeared during follow-up: macular pucker, choroidal neovascularization (CNV), subretinal pigmentary clumps, and flat irregular pigmented epithelium detachment. A few treatments were proven in serous retinal detachment cases but were ineffective in restoring vision.
In DSM, vision may be stable for years while macular changes progress: the macular bulge increases as does retinal pigment epithelium atrophy.
圆顶状黄斑（DSM）可能导致视力受损。本研究分析了DSM的长期演变情况，尤其是黄斑变化：浆液性视网膜脱离、视网膜色素上皮萎缩以及DSM隆起增加。
对29只患有DSM的眼睛进行回顾性研究。回顾了临床数据、彩色照片、荧光素血管造影和光学相干断层扫描检查结果。对患者进行了6个月至111个月（平均37.89个月）的随访。研究了黄斑隆起的高度、视网膜色素上皮黄斑萎缩的大小以及浆液性视网膜脱离的进展情况。记录了其他黄斑变化。
平均视力保持稳定。圆顶状黄斑高度从338.9μm显著增加至364.3μm（P = 0.007）。29只眼中最初有15只存在浆液性视网膜脱离；4例病情加重，7例自发缓解。黄斑视网膜色素上皮萎缩与隆起高度相关（P = 0.015），且在随访期间扩大（1.12对1.34，P = 0.04）。最初或随访期间出现了其他黄斑异常：黄斑皱襞、脉络膜新生血管（CNV）、视网膜下色素团块和平坦不规则色素上皮脱离。在浆液性视网膜脱离病例中证实了一些治疗方法，但对恢复视力无效。
在DSM中，黄斑变化进展时视力可能多年保持稳定：黄斑隆起增加，视网膜色素上皮萎缩也增加。
