Dome-shaped macula in eyes with myopic posterior staphyloma.
OBJECTIVE
To describe an unusual feature in myopic eyes responsible for visual loss, which we call a dome-shaped macula.


METHODS
Retrospective, observational case series.


METHODS
After observing isolated cases of dome-shaped macula, we analyzed optical coherence tomography (OCT) scans of 140 highly myopic eyes present in our OCT database to find similar cases. Fifteen eyes of 10 patients had a dome-shaped macula. These patients all had undergone fluorescein angiography (FA), indocyanine green angiography (ICGA), and B-scan ultrasonography examinations.


RESULTS
The mean refractive error of the affected eyes was -8.25 diopters (D; range, -2 to -15 D). Median visual acuity was 20/50. Recent visual impairment was noted in 11 of the 15 eyes studied, and metamorphopsia was noted in eight eyes. Four eyes were asymptomatic. FA showed atrophic changes in the macular retinal pigment epithelium (RPE) in all eyes, combined with focal points of leakage in seven of the 15 eyes. The dome-shaped appearance of the macula was visible on both B-scan ultrasonography and OCT: a characteristic bulge of the macular retina, RPE, and choroid within the concavity of the moderate posterior staphyloma was present in all eyes. In 10 eyes, OCT also showed a shallow foveal detachment at the top of the dome-shaped macula.


CONCLUSIONS
A dome-shaped macula within a myopic staphyloma is an unreported type of myopic posterior staphyloma. The dome-shaped macula often is associated with RPE atrophic changes and foveal retinal detachment, which may explain the visual impairment in these eyes.
Gaucher
David
D
Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Service d'Ophtalmologie, Université Paris 7, Paris, France.
Erginay
Ali
A
Lecleire-Collet
Amelie
A
Haouchine
Belkacem
B
Puech
Michel
M
Cohen
Salomon-Yves
SY
Massin
Pascale
P
Gaudric
Alain
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015862:Choroid Diseases / Q000175:diagnosis* / Q000209:etiology; D004396:Coloring Agents; D004108:Dilatation, Pathologic; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008266:Macula Lutea / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*; D010857:Pigment Epithelium of Eye / Q000000981:diagnostic imaging / Q000473:pathology*; D012030:Refractive Errors / Q000209:etiology; D012164:Retinal Diseases / Q000175:diagnosis* / Q000209:etiology; D012189:Retrospective Studies; D014463:Ultrasonography; D014792:Visual Acuity
D004396:Coloring Agents; D007208:Indocyanine Green