Lorenzo Daniel, Arias Luis, Choudhry Netan, Millan Eduard, Flores Ignacio, Rubio Marcos J, Cobos Estefanía, García-Bru Pere, Filloy Alejandro, Caminal Josep M
*Department of Ophthalmology, Bellvitge University Hospital, Barcelona, Spain; and†Herzig Eye Institute, Toronto, Canada.
Retina. 2017 Apr;37(4):680-686. doi: 10.1097/IAE.0000000000001222.
To study the long-term clinical course of dome-shaped macula in myopic eyes and to evaluate treatment efficacy for subretinal fluid (SRF) as a related complication.
A retrospective, single-center consecutive case series study was conducted. The authors analyzed myopic eyes with dome-shaped macula in patients who presented for evaluation of decreased vision. Dome-shaped macula was defined as a convexity of the retina-choroidal macular complex seen on spectral domain optical coherence tomography images. All patients were followed for at least 12 months (mean, 25 months). Fluorescein angiography and/or indocyanine green angiography were performed in cases with SRF to rule out choroidal neovascularization.
A total of 56 dome-shaped macula eyes from 36 patients were included in the study (bilateral in 55% of patients). Mean patient age was 56.9 ± 13.1 years. The mean spherical equivalent was -9.1 ± 6.0 diopters; 53% of eyes were considered highly myopic (>-6 diopters) and 47% of eyes were mildly myopic. In most cases (37 eyes; 66.1%), the dome-shaped macula was detected on vertical spectral domain optical coherence tomography scan patterns. No significant changes (P ≥ 0.1) were observed in mean best-corrected visual acuity or mean central foveal thickness from baseline to final follow-up. Subretinal fluid was present in 29 eyes (51.8%) at baseline, with no differences in best-corrected visual acuity in eyes with and without SRF (P ≥ 0.05). Nineteen of the 29 SRF eyes were treated: 8 underwent low-fluence photodynamic therapy, whereas 7 received bevacizumab, and 4 ranibizumab. No significant differences were found between treated and untreated SRF eyes in best-corrected visual acuity improvement (P ≥ 0.1), or complete resolution of SRF (P ≥ 0.1). Likewise, photodynamic therapy did not yield any significant benefit versus untreated eyes in best-corrected visual acuity or improvement of SRF.
Dome-shaped macula is a condition associated with myopic eyes that seems to remain stable over time in terms of vision and macular profiles. It is often associated with chronic SRF, for which no effective treatment is current available. However, SRF does not seem to be a significant cause of visual impairment.
研究近视眼穹窿状黄斑的长期临床病程，并评估作为相关并发症的视网膜下液（SRF）的治疗效果。
进行了一项回顾性、单中心连续病例系列研究。作者分析了因视力下降前来评估的患者中患有穹窿状黄斑的近视眼。穹窿状黄斑定义为在光谱域光学相干断层扫描图像上可见的视网膜-脉络膜黄斑复合体的凸起。所有患者均随访至少12个月（平均25个月）。对于有SRF的病例，进行荧光素血管造影和/或吲哚菁绿血管造影以排除脉络膜新生血管。
该研究共纳入了36例患者的56只穹窿状黄斑眼（55%的患者为双眼患病）。患者平均年龄为56.9±13.1岁。平均等效球镜度为-9.1±6.0屈光度；53%的眼睛被认为是高度近视（>-6屈光度），47%的眼睛为轻度近视。在大多数病例（37只眼；66.1%）中，在垂直光谱域光学相干断层扫描模式下检测到穹窿状黄斑。从基线到最终随访，平均最佳矫正视力或平均中心凹厚度未观察到显著变化（P≥0.1）。基线时29只眼（51.8%）存在视网膜下液，有和没有SRF的眼睛在最佳矫正视力方面无差异（P≥0.05）。29只SRF眼中的19只接受了治疗：8只接受了低剂量光动力疗法，7只接受了贝伐单抗治疗，4只接受了雷珠单抗治疗。在最佳矫正视力改善方面（P≥0.
