Department of Ophthalmology, Santiago de Compostela University Medical School, Santiago de Compostela, Spain.
Department of Ophthalmology, Virgen de la Victoria University Hospital and School of Medicine, Málaga, Spain.
Retina. 2019 Mar;39(3):587-593. doi: 10.1097/IAE.0000000000001970.
This study investigated factors associated with persistent serous retinal detachment in highly myopic eyes with vertical oval-shaped domes.
Twenty-eight highly myopic patients (40 eyes) with smooth macular elevations related to a vertical oval-shaped dome were recruited. Serous retinal detachment was investigated; 11 eyes had persistent submacular fluid (study group) and 29 eyes lacked submacular fluid (control group). All patients underwent complete ophthalmologic examinations, including axial-length measurement and fluorescein angiography. Spectral domain optical coherence tomography scans through the fovea measured choroidal thicknesses, macular bulge height, and vitreoretinal interface factors.
No studied variables (age, sex, spherical equivalence, axial length, vitreomacular traction, epiretinal membrane, and internal limiting membrane detachment) except higher macular bulge height (P = 0.03) and a reduced macular choroidal thickness (P = 0.02) were associated with the risk of serous retinal detachment. No statistically significant differences in best-corrected visual acuity were observed between the study and control groups. Serous retinal detachment always occurred at the top of the inward incurvation of the macula and was characterized by multiple hyperfluorescent granular patches on fluorescein angiography.
A higher macular bulge height and a reduced macular choroidal thickness might be important factors in the development of serous retinal detachment in patients with vertical oval-shaped domes.
本研究旨在探讨垂直椭圆形隆起的高度近视眼中持续性浆液性视网膜脱离的相关因素。
共招募了 28 名（40 只眼）存在与垂直椭圆形隆起相关的光滑性黄斑隆起的高度近视患者。研究了浆液性视网膜脱离情况；11 只眼存在黄斑下积液（研究组），29 只眼无黄斑下积液（对照组）。所有患者均接受了全面的眼科检查，包括眼轴长度测量和荧光素血管造影。通过黄斑中心凹进行光谱域光学相干断层扫描，测量脉络膜厚度、黄斑隆凸高度和玻璃体视网膜界面因素。
除黄斑隆凸高度较高（P = 0.03）和黄斑脉络膜厚度降低（P = 0.02）外，研究组与对照组之间没有其他研究变量（年龄、性别、球镜等效、眼轴长度、玻璃体黄斑牵引、视网膜前膜和内界膜脱离）与浆液性视网膜脱离的风险相关。两组患者最佳矫正视力无统计学差异。浆液性视网膜脱离始终发生在黄斑内凹的顶部，荧光素血管造影显示多个高荧光颗粒状斑块。
黄斑隆凸高度较高和黄斑脉络膜厚度降低可能是垂直椭圆形隆起患者发生浆液性视网膜脱离的重要因素。
