Department of Vitreo-Retinal Services, L.V. Prasad Eye Institute, MTC Campus, Bhubaneswar, Odisha, India.
Department of Ophthalmology, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore.
Eye (Lond). 2021 Sep;35(9):2458-2467. doi: 10.1038/s41433-021-01518-w. Epub 2021 Apr 19.
First described by Gaucher and associates in 2008 in eyes with high myopia, dome-shaped maculopathy (DSM) is an anterior convex protrusion of the macula towards the vitreous cavity observable on OCT. This seems to be related to a localized scleral thickness, which might be the result of regional variation in the scleral bio-mechanical properties and the process of emmetropization causing asymmetric scleral growth. The presence of DSM can be associated with an increased risk of complications. The clinical spectrum ranges from being asymptomatic to metamorphopsia and mild-to-moderate gradual visual loss over years. Visual impairment in DSM results from retinal pigment epithelial changes, sub-foveal serous detachment, retinoschisis and myopic choroidal neovascularization. In this review, we compile and review the available information on the pathophysiology, nomenclature, classification, clinical features including imaging, differential diagnosis, complications associated with DSM and the gaps in our understanding of this entity thus far.
2008 年，Gaucher 等人首次在高度近视患者的眼中描述了这种疾病，其表现为黄斑区向前凸向玻璃体腔，在 OCT 上可观察到。这种情况似乎与局部巩膜厚度有关，这可能是巩膜生物力学特性的区域变化和导致巩膜不对称生长的正视化过程的结果。DSM 的存在可能与并发症风险增加有关。其临床表现从无症状到视物变形，再到数年内逐渐出现轻至中度视力丧失。DSM 导致的视力损害是由于视网膜色素上皮改变、黄斑下浆液性脱离、视网膜劈裂和近视性脉络膜新生血管形成。在这篇综述中，我们收集并回顾了目前关于其病理生理学、命名法、分类、包括影像学在内的临床特征、鉴别诊断、与 DSM 相关的并发症以及目前对该疾病认识的不足等方面的信息。
