Abstract
Objective: To report a case series of dome-shaped macula (DSM) and serous retinal detachment (SRD). Methods: A retrospective and observational case series study was performed at two centers of ophthalmology in Rosario-Argentina from January 2016 to December 2017. Eight eyes of 5 patients diagnosed with dome-shaped macula with subfoveal hyporeflective zone seen in optical coherence tomography (OCT) were included. Best-corrected visual acuity (BCVA), OCT, fluorescein angiography (FA), differential diagnoses, clinical course and different treatments were reviewed. Results: Baseline visual acuity ranged from 20/25 to 20/200. OCT revealed that the retinal choroidal macular complex had a convex shape and exhibited foveal neurosensory retinal detachment in all cases. FA showed mild diffuse hyperfluorescence due to changes in the retinal pigment epithelium (RPE). No sign of leakage was observed. Different treatments were used, including intravitreal antiangiogenic drugs, oral spironolactone, melatonin and observation. Follow-up time was between 6 and 18 months. BCVA and OCT findings remained unchanged after different options of treatment. Conclusions: DSM is an unusual entity, which can be confused with other maculopathies that cause neurosensory retinal detachment and do not respond to different types of treatment. Hence, in our opinion, observation is a reasonable approach for this disorder.
Highlights
Serous retinal detachment (SRD) without choroidal neovascularization is a well-known complication of dome-shaped macula (DSM) and it is rarely reported in the absence of DSM [4]
Few reports describing the successful treatment of serous retinal detachment (SRD) associated with DSM have been published, and the results reported in different reports have been variable
The objective of this study is to present five cases of DSM with SRD, including their refractive characteristics, clinical courses and the lack of successful results following a variety of therapeutic attempts
Summary
Dome shaped macula (DSM) was first described by Gaucher et al as a rare find-. The estimated prevalence of DSM was reported as 9.3% - 10.7% in highly myopic eyes [1] [2] and 18% in patients with choroidal neovascularization (CNV) secondary to pathologic myopia [3]. Serous retinal detachment (SRD) without choroidal neovascularization is a well-known complication of DSM and it is rarely reported in the absence of DSM [4]. While its physiopathological mechanism is still unknown, different theories have been proposed and include a thickening of the choroid [1] or a subfoveal scleral thickening that affects the flow of choroidal fluid [5]
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