Three-dimensional tomographic features of dome-shaped macula by swept-source optical coherence tomography

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Imaging

Background:

• Dome-shaped macula is a recognized anomaly in highly myopic eyes.
• Understanding its pathomorphology is crucial for managing associated complications.
• Swept-source optical coherence tomography (OCT) provides high-resolution imaging of the posterior pole.

Purpose of the Study:

• To investigate the tomographic and pathomorphologic features of dome-shaped maculas.
• To characterize the morphology of the posterior staphyloma in these eyes using swept-source OCT.

Main Methods:

• A prospective, cross-sectional study involving 51 highly myopic eyes with dome-shaped maculas.
• High-resolution 3D imaging using swept-source OCT (1050 nm) with raster scanning.
• Autosegmentation of the retinal pigment epithelium (RPE) to construct 3D images of the posterior pole.

Main Results:

• Reconstructed 3D RPE images revealed two outward concavities within the posterior staphyloma, bridged by a horizontal ridge.
• This ridge was band-shaped in 42 eyes; 9 eyes showed a typical dome-shaped convexity.
• Significant scleral thinning was observed corresponding to RPE concavities, with foveal sclera thicker than parafoveal sclera.

Conclusions:

• A horizontal ridge within the posterior staphyloma is a characteristic feature of dome-shaped maculas in highly myopic eyes.
• This ridge is formed by uneven scleral thinning, particularly evident in the parafoveal regions.
• Swept-source OCT effectively visualizes these intricate structural changes, aiding in understanding the condition's pathogenesis.