Soudier Guillaume, Gaudric Alain, Gualino Vincent, Nardin Mathieu, Speeg-Schatz Claude, Gaucher David
Ophtalmology, Nouvel Hôpital Civil, Strasbourg, France.
University Hospital of Lariboisière, University Paris 7, Paris, France.
Case Rep Ophthalmol. 2017 Nov 16;8(3):515-520. doi: 10.1159/000481703. eCollection 2017 Sep-Dec.
Dome-shaped macula (DSM) is an entity recently described as a convex anterior protrusion of the macular area within a posterior myopic staphyloma. Specific complications were associated with DSM, like serous retinal detachment (SRD). We describe a woman presenting with a decreased vision at 20/50. SD-OCT scans were performed, showing a macular bulge. SRD was present and an epiretinal membrane could also be observed. Fluorescein angiography and indocyanin green angiography did not show any leakage nor choroidal neovascularization. Epiretinal membrane peeling was performed, and 3 months after surgery, SRD completely disappeared. However, SRD reappeared 1 year after surgery and enlarged within 2 years following surgery. In conclusion, two mechanisms could be considered for physiopathology of SRD: first, the epiretinal membrane may have exerted traction on the macular retina, second, vitreous body might constitute a tank for cytokines and/or other factors, triggering subretinal fluid accumulation, leading to SRD.
圆顶状黄斑（DSM）是一种最近被描述为后极部近视性葡萄肿内黄斑区向前凸出的病变。DSM会伴有特定的并发症，如浆液性视网膜脱离（SRD）。我们描述了一名视力下降至20/50的女性。进行了频域光学相干断层扫描（SD - OCT），显示黄斑隆起。存在SRD，还可观察到视网膜前膜。荧光素血管造影和吲哚菁绿血管造影未显示任何渗漏及脉络膜新生血管。进行了视网膜前膜剥除术，术后3个月，SRD完全消失。然而，术后1年SRD复发，并在术后2年内扩大。总之，SRD的病理生理机制可考虑两点：其一，视网膜前膜可能对黄斑视网膜施加了牵引力；其二，玻璃体可能构成细胞因子和/或其他因素的储存池，引发视网膜下液积聚，导致SRD。
