Dormegny Lea, Liu Xuanli, Philippakis Elise, Tadayoni Ramin, Bocskei Zsolt, Bourcier Tristan, Sauer Arnaud, Gaudric Alain, Speeg-Schatz Claude, Gaucher David
Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, Strasbourg, France.
Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Am J Ophthalmol. 2021 Apr;224:18-29. doi: 10.1016/j.ajo.2020.11.013. Epub 2020 Dec 4.
To determine the mechanism behind macular bulge height increase in eyes with dome-shaped macula (DSM).
Retrospective, observational case series.
Eyes presenting with DSM followed up for a minimum of 1 year were examined using ocular biometry and spectral-domain optical coherence tomography at baseline and at end of follow-up. Axial length (AL), DSM bulge height, and central and peripheral choroidal thickness (nasal, temporal, superior, and inferior quadrants) were reported. Eyes were categorized into 2 groups for comparison: the "mini-DSM" group (DSM < 100 μm) and the "classic" DSM group (DSM > 100 μm).
Fifty-eight eyes (33 patients) were studied: 32 (55%) were classic DSM and 26 (45%) mini-DSM. During the mean follow-up of 51.76 ± 36.01 months, mean AL increased from 26.99 ± 2.94 mm to 27.12 ± 3.09 mm (P = .010) and mean macular bulge height increased from 235.88 ± 282.47 μm to 262.34 ± 317.15 μm (P < .001). DSM height change was significantly higher than AL change (P < .001). Mean peripheral choroidal thickness significantly decreased nasally (P = .008), temporally (P = .026), and inferiorly (P < .001). Mini-DSM eyes exhibited shorter AL (26.17 vs 27.66 mm; P = .027), greater visual acuity (0.169 vs 0.437 logMAR; P = .002), and fewer macular complications compared to classic DSM eyes.
Macular bulge increase in DSM is associated with eye elongation and overall thinning of the peripheral choroid. DSM might result from differential elongation of the eye predominant in the peri-dome region. Mini-DSM (ie, inferior to 100 μm) are characterized by slower evolution, better visual prognosis, and fewer complications compared to "classic" DSM.
确定穹窿状黄斑（DSM）眼黄斑隆起高度增加背后的机制。
回顾性观察病例系列。
对至少随访1年的DSM患者的眼睛在基线和随访结束时使用眼生物测量和光谱域光学相干断层扫描进行检查。报告眼轴长度（AL）、DSM隆起高度以及中央和周边脉络膜厚度（鼻侧、颞侧、上方和下方象限）。将眼睛分为2组进行比较：“微型DSM”组（DSM<100μm）和“经典”DSM组（DSM>100μm）。
共研究了58只眼（33例患者）：32只（55%）为经典DSM，26只（45%）为微型DSM。在平均51.76±36.01个月的随访期间，平均AL从26.99±2.94mm增加到27.12±3.09mm（P = 0.010），平均黄斑隆起高度从235.88±282.47μm增加到262.34±317.15μm（P < 0.001）。DSM高度变化显著高于AL变化（P < 0.001）。平均周边脉络膜厚度在鼻侧（P = 0.008）、颞侧（P = 0.026）和下方（P < 0.001）显著降低。与经典DSM眼相比，微型DSM眼的AL较短（26.17对27.66mm；P = ）、视力更好（0.169对0.437 logMAR；P = 0.002）且黄斑并发症更少。
DSM中黄斑隆起增加与眼球延长和周边脉络膜整体变薄有关。DSM可能是由于眼球在穹窿周围区域的差异延长所致。与“经典”DSM相比，微型DSM（即低于100μm）的特点是进展较慢、视觉预后较好且并发症较少。
