The extended clinical phenotype of dome-shaped macula.
OBJECTIVE
To describe the phenotype, associations, and complications of dome-shaped macula (DSM) through the combination of spectral-domain optical coherence tomography (OCT) imaging and B-scan ultrasonography, when available. This retroprospective cohort study aims to gain further pathophysiological understanding in eyes with DSM.


METHODS
Fifty-eight eyes of 36 patients were identified as having OCT features of DSM. Retinal and choroidal thicknesses were determined from enhanced depth imaging (EDI)-OCT image sets, with scleral thickness subsequently calculated by subtraction from the B-scan ultrasound-derived measurements of posterior coat thickness.


RESULTS
DSM was associated with myopia in 81 % of eyes. The underlying clinical diagnosis was variable: central serous chorioretinopathy (CSCR)-like entity, choroidal neovascularization, and inherited retinal disorders. The subfoveal choroidal thickness of the nine highly myopic eyes with a CSCR-like phenotype was thicker than the 25 eyes without CSCR (p = 0.169). The mean subfoveal scleral thickness of the highly myopic eyes was 585 ± 196 μm, which was significantly different from those with a refractive error less than 6 diopters (1133 ± 290 μm) (P < 0.0001).


CONCLUSIONS
This study highlights the novel observation of a thickened choroid when CSCR is present. In addition, we expand the associations of DSM to eyes with hypermetropia and acquired disease, and to those with inherited retinal dystrophies.
NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK, marie-helene.errera@orange.fr.
Marie-Hélène
MH
Errera
Michel
M
Michaelides
Pearse A
PA
Keane
Marie
M
Restori
Michel
M
Paques
Anthony T
AT
Moore
Jonathan
J
Yeoh
Derek
D
Chan
Catherine A
CA
Egan
Praveen J
PJ
Patel
Adnan
A
Tufail
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056833:Central Serous Chorioretinopathy / Q000175:diagnosis; D002648:Child; D002829:Choroid / Q000473:pathology; D020256:Choroidal Neovascularization / Q000175:diagnosis; D015331:Cohort Studies; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009216:Myopia / Q000175:diagnosis; D010641:Phenotype; D012164:Retinal Diseases / Q000175:diagnosis*; D012189:Retrospective Studies; D012590:Sclera / Q000473:pathology; D041623:Tomography, Optical Coherence; D014463:Ultrasonography; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
D004396:Coloring Agents; D007208:Indocyanine Green