Session Title: Imaging IV
Session Date/Time: Sunday 20/09/2015 | 11:00-13:00
Paper Time: 12:44
First Author: : D.Lorenzo Parra SPAIN
Co Author(s): : E. Millan N. Choudhry L. Arias I. Flores M. Estefania Cobos P. Josep Maria Caminal
PURPOSE:To investigate the clinical course of dome-shaped macula (DSM) in myopic eyes and evaluate treatment responses for serous retinal detachment (SRD) as a related complication.
Retrospective, observational case series with a minimal of 12-month follow-up (mean: 23 months).
We analyzed data from DSM eyes of patients who underwent complete ophthalmic evaluation due to decreased vision. DSM was defined as a convexity of the retina-choroidal macular complex on horizontal, vertical or both scans by spectral-domain optical coherence tomography (SD-OCT) images. Fluorescein angiography and/or indocyanine green angiography were only performed in cases with SRD, in order to rule out choroidal neovascularization.
We studied 56 DSM eyes in 36 patients with a mean age of 56.9 ± 13.1 years (unilateral in 16 patients, 44%; bilateral in 20 patients, 55.6%). The mean spherical equivalent was -9.1 ± 6.0 diopters. SD-OCT scan patterns detected the bulge anatomy as follow: 37 eyes (66.1%) in vertical scans, 14 eyes (25%) in horizontal scans and 5 eyes (8.9%) in both scans. The mean initial best-corrected visual acuity (BCVA) was 0.48 (logMAR); at the last visit, it was 0.52 (p≥ 0.1). Baseline SRD was exhibited in 29 eyes (51.8%). BCVA was not significantly lower in eyes with SRD than in eyes without SRD (p≥ 0.05). A total of 19 eyes with SRD were treated (8 eyes with low-fluence photodynamic therapy, 7 eyes with bevacizumab, and 4 eyes with ranibizumab), and 10 eyes with SRD did not receive any treatment. Statistically significant results were not found on improvement of BCVA (p≥ 0.1), and on resolution of SRF (p≥ 0.1), in the comparison between the treatment and non-treatment groups.
DSM is a condition related to highly myopic eyes that is often associated with chronic SRD, for which no effective treatment can be applied. In these cases, SRD cannot be considered as a significant cause of visual impairment.