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Invest Ophthalmol Vis Sci. 2020 Mar 9;61(3):19. doi: 10.1167/iovs.61.3.19.
The purpose of this study was to analyze the clinical features of dome-shaped macula (DSM) in highly myopic eyes and its morphological relationship with myopic retinoschisis (MRS).
In this cross-sectional study, 409 eyes of 409 patients with high myopia who had spectral-domain optical coherence tomography (OCT) examinations were included. The associations of DSM with the distribution of MRS and ocular biometry were evaluated.
Of 409 eyes, DSM was detected in 64 eyes (15.6%). The eyes with DSM were more myopic (-18.8 ± 3.9 vs. -13.4 ± 5.9; P < 0.001) and had longer axial length (31.7 ± 2.4 vs. 29.5 ± 2.5; P < 0.001) compared with those without DSM. A higher rate of extrafoveal retinoschisis (35.9% vs. 9.6%; P < 0.001) and a lower rate of foveoschisis (10.9% vs. 26.1%; P = 0.01) were detected in the eyes with DSM compared with those without DSM. In the eyes with DSM, MRS was detected in 30 eyes (46.9%). MRS predominantly affected the extrafoveal area (76.7%), especially the base of the dome (82.6%). The extrafoveal retinoschisis was most frequently distributed in the superior quadrant (52.2%). None of the eyes with DSM displayed fovea-only retinoschisis. The ratio of the height and width of the macular bulge was higher in eyes with MRS than those without MRS (0.05 vs. 0.04; P = 0.001).
A DSM is found in highly myopic eyes with a longer axial length. MRS in eyes with DSM is more likely to affect the extrafoveal area, especially the base of the dome. A steeper macular bulge is associated with the occurrence of MRS.
本研究旨在分析高度近视眼中穹窿形黄斑（DSM）的临床特征及其与近视性板层视网膜劈裂（MRS）的形态关系。
在这项横断面研究中，纳入了 409 名高度近视患者的 409 只眼，这些患者均接受了频域光相干断层扫描（OCT）检查。评估了 DSM 与 MRS 分布和眼生物测量的相关性。
在 409 只眼中，64 只眼（15.6%）检测到 DSM。与无 DSM 的眼相比，有 DSM 的眼更近视（-18.8 ± 3.9 与 -13.4 ± 5.9；P < 0.001）且眼轴更长（31.7 ± 2.4 与 29.5 ± 2.5；P < 0.001）。有 DSM 的眼出现周边部视网膜劈裂（35.9% 与 9.6%；P < 0.001）的比例较高，而出现黄斑劈裂（10.9% 与 26.1%；P = 0.01）的比例较低。在有 DSM 的眼中，30 只眼（46.9%）检测到 MRS。MRS 主要影响周边部区域（76.7%），尤其是穹窿的底部（82.6%）。周边部视网膜劈裂最常分布于上象限（52.2%）。无 DSM 的眼中均未出现仅有黄斑劈裂。有 MRS 的眼的黄斑隆凸高度与宽度之比高于无 MRS 的眼（0.05 与 0.04；P = 0.001）。
在更长眼轴的高度近视眼中发现了 DSM。有 DSM 的眼中的 MRS 更可能影响周边部区域，尤其是穹窿的底部。更陡峭的黄斑隆凸与 MRS 的发生相关。
