title: LONG-TERM EVOLUTION OF DOME-SHAPED MACULA: Increased Macular Bulge is Associated With Extended Macular Atrophy.
abstract: OBJECTIVE
  Dome-shaped macula (DSM) may cause impaired vision. This study analyzed the long-term evolution of DSM, most particularly macular changes: serous retinal detachment, retinal pigment epithelium atrophy, and DSM bulge increase.
  
  
  METHODS
  Twenty-nine eyes presenting with DSM were retrospectively studied. Clinical data, color photographs, fluorescein angiographs, and optical coherence tomography examinations were reviewed. Patients were followed up from 6 months to 111 months (mean, 37.89 months). The height of the macular bulge, the size of retinal pigment epithelium macular atrophy, and serous retinal detachment progression were studied. Other macular changes were noted.
  
  
  RESULTS
  Mean vision remained stable. Dome-shaped macula height increased significantly from 338.9 μm to 364.3 μm (P = 0.007). Serous retinal detachment was present initially in 15 of 29 eyes; it increased in 4 cases and resolved spontaneously in 7. Macular retinal pigment epithelium atrophy correlated with the bulge height (P = 0.015), and it enlarged during follow-up (1.12 vs. 1.34, P = 0.04). Other macular anomalies were present initially or appeared during follow-up: macular pucker, choroidal neovascularization (CNV), subretinal pigmentary clumps, and flat irregular pigmented epithelium detachment. A few treatments were proven in serous retinal detachment cases but were ineffective in restoring vision.
  
  
  CONCLUSIONS
  In DSM, vision may be stable for years while macular changes progress: the macular bulge increases as does retinal pigment epithelium atrophy.
authors.affiliation: *Nouvel hôpital civil, University hospital of Strasbourg, France; †Bacteriological Laboratory (EA-7290), Federation Medicine, Translational of Strasbourg, University of Strasbourg, France; and ‡University hospital of Lariboisière, University Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Soudier
authors.forename: Alain
authors.initials: A
authors.lastname: Gaudric
authors.forename: Vincent
authors.initials: V
authors.lastname: Gualino
authors.forename: Pascale
authors.initials: P
authors.lastname: Massin
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nardin
authors.forename: Ramin
authors.initials: R
authors.lastname: Tadayoni
authors.forename: Claude
authors.initials: C
authors.lastname: Speeg-Schatz
authors.forename: David
authors.initials: D
authors.lastname: Gaucher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D058452:Axial Length, Eye / Q000473:pathology; D004108:Dilatation, Pathologic; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D008266:Macula Lutea / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications* / Q000473:pathology; D012163:Retinal Detachment / Q000209:etiology*; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D012189:Retrospective Studies; D012590:Sclera / Q000473:pathology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology