Dome-shaped macula phenomenon

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Abstract

This article provides a review of the literature of domestic and foreign studies on the newly described, insufficiently explored and poorly diagnosed pathology of the organ of vision – the dome-shaped macula (DSM). This pathology is an anatomical feature of the structure of the eye and is formed in most cases at medium and high myopia. For the first time, this condition was revealed in 2008 with the help of high resolution optical coherence tomography, and is characterized by local thickening of the sclera in the macular area with dome formation. Currently the final reason for DSM formation is not yet found. Studies are conducted to identify the mechanisms for the formation of this feature and to predict the variants of its course. Particular attention in the article is paid to the review of various changes in the retina and pigment epithelium in patients with dome-shaped macula. Methods and features of diagnosis of this condition, as well as differential diagnosis with choroidal hemangioma, which is very difficult, are also considered. The article presents an overview of current methods of treating this condition. Failures, as well as effective and promising methods of treating the neurosensory retinal detachment, occurring on the background of the dome-shaped macula, are described. Timely and correct diagnosis on the basis of characteristic clinical picture allows to avoid ineffective treatment, as well as to select the necessary set of diagnostic procedures for dynamic observation and identification of features of the disease.

About the authors

Mariya V. Melikhova

Interdisciplinary Scientific and Technical Complex named after Academician S.N. Fedorov,  Saint Petersburg branch

Author for correspondence.
Email: a.m.v@bk.ru
SPIN-code: 7718-0933

MD, Ophthalmologist

Russian Federation, Saint Petersburg

Marina V. Gatsu

Interdisciplinary Scientific and Technical Complex named after Academician S.N. Fedorov,  Saint Petersburg branch

Email: m-gatsu@yandex.ru

MD, PhD, DMedSc, Vice-head in Clinical Organizational Work

Russian Federation, Saint Petersburg

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2. Fig. 1. Tomogram of the macular area of the retina in high myopia (Optovue RTVue XR 100 Avanti). On the transversal scan, the outer and inner layers of the retina are well visualized. The contrasting line of the pigment epithelium is dome-shaped, underneath it there is an uneven layer of choroid vessels (short line) with a pronounced thickening of the sclera beneath it (long line)

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3. Fig. 2. Tomogram of the macular area of the retina in a patient with high myopia without dome-shaped macula (Optovue RTVue XR 100 Avanti). On the tomogram, the pigment epithelium line is smooth, there is no elevation, under it the choroid and sclera have an uniform structure, have an equal thickness throughout

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Copyright (c) 2018 Melikhova M.V., Gatsu M.V.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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