Lee Jeong Hyun, Jeon Woosung, Kim Min Seok, Joo Kwangsic, Woo Se Joon, Shin Joo Young, Ahn Jeeyun
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
Graefes Arch Clin Exp Ophthalmol. 2025 Mar 25. doi: 10.1007/s00417-025-06802-z.
To investigate the morphological characteristics of dome-shaped macula (DSM) and inferior staphyloma complicated by serous retinal detachment (SRD).
Electronic medical records and multimodal images of patients diagnosed with DSM and inferior staphyloma were retrospectively reviewed. Morphological features, including axial length, curvature height, orientation of the dome, presence of retinal pigment epithelial detachment, choroidal vascular features such as subfoveal choroidal thickness, variations in choroidal thickness, presence of abrupt changes in choroidal thickness and presence of large choroidal vessels were analyzed.
Fifty-three eyes of 37 patients were included, of which 33 eyes had DSM and 20 eyes had inferior staphyloma, and 15 (28.3%) were complicated with SRD. Four (12.1%) of the DSM and 11 (55.0%) of the inferior staphyloma eyes had SRD. On univariate analysis of risk factors for SRD, shorter axial length (p = 0.002), presence of inferior staphyloma (p = 0.004), higher subfoveal curve height (p = 0.009), thicker subfoveal choroidal thickness (p = 0.038), greater variation in choroidal thickness (p = 0.005), presence of both abrupt changes in choroidal thickness (p < 0.001) and large choroidal vessels (p = 0.001) showed a significantly higher risk. On multivariate analysis, shorter axial length (p = 0.038) and presence of abrupt changes in choroidal thickness (p = 0.008) were identified as significant risk factors for SRD.
SRD was more prevalent in eyes with inferior staphyloma compared to DSM. Shorter axial length and abrupt changes in choroidal thickness were associated risk factors for SRD.
研究穹窿状黄斑（DSM）和合并浆液性视网膜脱离（SRD）的下方巩膜葡萄肿的形态学特征。
回顾性分析诊断为DSM和下方巩膜葡萄肿患者的电子病历和多模态图像。分析形态学特征，包括眼轴长度、曲率高度、穹窿方向、视网膜色素上皮脱离的存在情况、脉络膜血管特征，如黄斑下脉络膜厚度、脉络膜厚度变化、脉络膜厚度突然变化的存在情况以及大脉络膜血管的存在情况。
纳入37例患者的53只眼，其中33只眼有DSM，20只眼有下方巩膜葡萄肿，15只眼（28.3%）合并SRD。DSM组4只眼（12.1%）和下方巩膜葡萄肿组11只眼（55.0%）发生SRD。对SRD危险因素进行单因素分析时，较短的眼轴长度（p = 0.002）、下方巩膜葡萄肿的存在（p = 0.004）、较高的黄斑下曲线高度（p = 0.009）、较厚的黄斑下脉络膜厚度（p = 0.038）、脉络膜厚度的较大变化（p = 0.005）、脉络膜厚度突然变化的存在（p < 0.001）和大脉络膜血管的存在（p = 0.001）显示出显著更高的风险。多因素分析时，较短的眼轴长度（p = 0.038）和脉络膜厚度突然变化的存在（p = 0.008）被确定为SRD的显著危险因素。
与DSM相比，SRD在下方巩膜葡萄肿眼中更常见。较短的眼轴长度和脉络膜厚度突然变化是SRD的相关危险因素。
