Department of Ophthalmology, University of Padova, Padova, Italy.
G.B. Bietti Foundation, IRCCS, Roma, Italy.
Retina. 2018 May;38(5):922-930. doi: 10.1097/IAE.0000000000001621.
To investigate retinal sensitivity (Se) in dome-shaped macula (DSM) using microperimetry and to correlate functional findings to specific spectral domain optical coherence tomography features.
Patients affected by DSM in at least 1 eye were consecutively enrolled in a prospective, cross-sectional study. All studied eyes performed best-corrected visual acuity measurement, microperimetry to assess Se and optical coherence tomography to investigate DSM pattern and to measure bulge height and retinal and choroidal thicknesses.
Fifty-three eyes of 29 patients were studied. Dome-shaped macula was vertically oriented (V-DSM) in 23 (43.4%), symmetric (S-DSM) in 17 (32.1%), and horizontally oriented (H-DSM) in 13 eyes (24.5%). Foveal subretinal fluid was present in 29/53 (54.7%) cases; it correlated to the bulge height (P < 0.0001) and determined a reduction of Se (P < 0.0001) not of best-corrected visual acuity (P = 0.7105). Mean Se was 13.9 ± 3.2 dB. Microperimetry parameters did not differ among the different DSM patterns. However, Se was significantly impaired if foveal subretinal fluid was present in V-DSM and in S-DSM, but not in H-DSM (V-DSM: P < 0.0001; S-DSM: P = 0.0252; H-DSM: P = 0.5723). In H-DSM, inferior choroidal thickness was thicker in cases with foveal subretinal fluid compared with those without it (P = 0.0363).
In DSM, Se evaluation better reflects the central functional impairment than best-corrected visual acuity, particularly when some optical coherence tomography features, such as foveal subretinal fluid and higher bulge height, are present.
使用微视野计研究穹窿形黄斑（DSM）的视网膜敏感性（Se），并将功能发现与特定的光谱域光相干断层扫描特征相关联。
连续纳入至少 1 只眼患有 DSM 的患者进行前瞻性、横断面研究。所有研究眼均行最佳矫正视力测量、微视野计评估 Se 以及光学相干断层扫描以研究 DSM 模式，并测量隆起高度以及视网膜和脉络膜厚度。
共研究了 29 名患者的 53 只眼。23 只眼（43.4%）为垂直型 DSM（V-DSM），17 只眼（32.1%）为对称型 DSM（S-DSM），13 只眼（24.5%）为水平型 DSM（H-DSM）。53 只眼中的 29 只（54.7%）存在黄斑中心凹下视网膜下积液；它与隆起高度相关（P<0.0001），并导致 Se 降低（P<0.0001），而不是最佳矫正视力降低（P=0.7105）。平均 Se 为 13.9±3.2dB。不同 DSM 模式之间的微视野计参数无差异。然而，如果 V-DSM 和 S-DSM 中存在黄斑中心凹下视网膜下积液，则 Se 明显受损，但在 H-DSM 中则不然（V-DSM：P<0.0001；S-DSM：P=0.0252；H-DSM：P=0.5723）。在 H-DSM 中，存在黄斑中心凹下视网膜下积液的病例其下脉络膜厚度较无积液者厚（P=0.0363）。
在 DSM 中，Se 评估比最佳矫正视力更能反映中心功能障碍，特别是在存在一些光学相干断层扫描特征（如黄斑中心凹下视网膜下积液和较高的隆起高度）时。
