Dome‐shaped macula in high myopia: Prevalence and clinical characteristics in a French cohort
Sebastiano Del Fabbro, Elise Philippakis, Matteo Maria Carlà, Songhomitra Panda‐Jonas, Jost Jonas, Alain Gaudric, Aude CouturierAbstract
Purpose
To determine the prevalence of dome‐shaped macula (DSM) in high myopia (HM) and to compare the clinical characteristics of eyes with and without DSM.
Methods
This retrospective, longitudinal, single‐centre cohort study included patients with HM, with or without DSM. Baseline demographic and clinical characteristics were collected. Multimodal imaging was performed at baseline and during follow‐up to assess the presence of macular neovascularization (MNV) and serous retinal detachment (SRD).
Results
A total of 1133 eyes of 619 HM patients (67% of women; mean [standard deviation] age: 48.9 [16.9] years) were analyzed. The eye‐level and patient‐level prevalences of DSM were 15% (173/1133 eyes) and 19% (117/619 patients), respectively. Compared to non‐DSM eyes, DSM eyes showed a longer axial length ( p < 0.001), a worse baseline visual acuity (VA) ( p = 0.016) and a higher prevalence of diffuse chorioretinal atrophy ( p = 0.013). The longitudinal analysis was limited to DSM eyes, with a mean follow‐up of 28.0 (44.2) months. At the final visit, MNV was found in 47 eyes (27%) and SRD in 10 eyes (6%). MNV incidence was 4.02 (95% confidence interval [CI]: 1.79–6.70) per 100 eye‐years. The presence of SRD at baseline was associated with a greater dome height (odds ratio = 1.007; p < 0.001). Vitreoretinal interface abnormalities were more frequently observed in eyes with lower dome height.
Conclusions
DSM was detected in approximately 15% of HM eyes. Patients with DSM showed a worse baseline VA compared to those without DSM. MNV was the most common and vision‐threatening complication, while SRD was relatively uncommon, occurring only in cases of significant bulging.