Jonas Jost B, Panda-Jonas Songhomitra, Wei Wen-Bin, Xu Jie, Wang Ya Xing
Rothschild Foundation Hospital, Institut Français de Myopie, Paris, France.
Singapore Eye Research Institute, Singapore, Singapore.
Acta Ophthalmol. 2025 Mar;103(2):177-185. doi: 10.1111/aos.16764. Epub 2024 Sep 27.
To explore the prevalence and associated factors of a dome-shaped macula (DSM) in a general population.
Out of the population-based Beijing Eye Study cohort (n = 3468 participants), the investigation included all eyes with an axial length of ≥25 mm, and a randomized sample of eyes with an axial length of <25 mm. Using optical coherence tomographic (OCT) images, we examined presence and height of DSMs, defined as an inward convexity of the foveal retinal pigment epithelium (RPE)/Bruch's membrane (BM) line, detectable in at least two OCT scans perpendicularly orientated to each other.
The study cohort consisted of 366 eyes (314 individuals) with a mean age of 63.7 ± 9.7 years and a mean axial length of 24.8 ± 2.1 mm (median: 25.1 mm; range: 18.96-30.88 mm). Prevalence of DSMs (found in 6/366 eyes; 1.9%; 95%CI: 1.0, 3.0) increased from 0/125 (0%) in non-myopic eyes to 1/152 (0.7%; 95%CI: 0.0, 2.0) in moderately myopic eyes, and to 6/83 (7.2%; 95%CI: 1.7, 12.7) in the highly myopic group. In multivariable analysis, higher DSM prevalence corelated with longer axial length (OR: 2.05; 95%CI: 1.36, 3.08; p < 0.001) and higher stage of myopic macular degeneration (OR: 1.08; 95%CI: 1.01, 1.16; p = 0.03). The mean maximal DSM height was 139 ± 107 μm (median: 100 μm; range: 25-350 μm). It was associated with higher stage of myopic macular degeneration (beta: 0.24; p < 0.001) and higher prevalence of macular BM defects (beta: 0.17; p < 0.001). None of the DSMs showed a serous retinal detachment or relative choroidal thickening.
Higher DSM prevalence correlated non-linearly with longer axial length, with DSM height increasing with the presence of a BM defect. DSMs may be associated with an axial elongation-related BM overproduction in the fundus midperiphery in all meridians.
探讨普通人群中穹窿状黄斑（DSM）的患病率及相关因素。
在基于人群的北京眼病研究队列（n = 3468名参与者）中，该调查纳入了所有眼轴长度≥25 mm的眼睛，以及眼轴长度<25 mm的眼睛的随机样本。使用光学相干断层扫描（OCT）图像，我们检查了DSM的存在情况和高度，DSM定义为中央凹视网膜色素上皮（RPE）/布鲁赫膜（BM）线向内凸出，在至少两次相互垂直的OCT扫描中可检测到。
研究队列包括366只眼睛（314名个体），平均年龄为63.7±9.7岁，平均眼轴长度为24.8±2.1 mm（中位数：25.1 mm；范围：18.96 - 30.88 mm）。DSM的患病率（在6/366只眼中发现；1.9%；95%CI：1.0，3.0）从非近视眼中的0/125（0%）增加到中度近视眼中的1/152（0.7%；95%CI：0.0，2.0），在高度近视组中增加到6/83（7.2%；95%CI：1.7，12.7）。在多变量分析中，较高的DSM患病率与较长的眼轴长度相关（OR：2.05；95%CI：1.36，3.08；p < 0.001）以及较高阶段的近视性黄斑变性相关（OR：1.08；95%CI：1.01，1.16；p = 0.03）。DSM的平均最大高度为139±107μm（中位数：100μm；范围：25 - 350μm）。它与较高阶段的近视性黄斑变性相关（β：0.24；p < 0.001）以及黄斑BM缺陷的较高患病率相关（β：0.17；p < 0.001）。所有DSM均未显示浆液性视网膜脱离或相对脉络膜增厚。
较高的DSM患病率与较长的眼轴长度呈非线性相关，DSM高度随BM缺陷的存在而增加。DSM可能与眼底中周部所有子午线方向上与眼轴伸长相关的BM过度生成有关。
