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DOME-SHAPED MACULOPATHY: ENHANCED VISUALIZATION WITH RADIAL OPTICAL COHERENCE TOMOGRAPHY SCANS
Joseph G Christenbury1, Nopasak Phasukkijwatana, Anna Tan
1*Retinal Disorders and Ophthalmic Genetics Division, Stein Eye Institute, UCLA, Los Angeles, California; †Vitreous Retina Macula Consultants of New York, New York, New York; ‡LuEsther T Mertz Retinal Research Center, Manhattan, Eye, Ear and Throat Hospital, New York, New York; §Singapore National Eye Center, Singapore Eye Research Institute, Singapore; ¶Department of Ophthalmology, New York University School of Medicine, New York, New York; ††Greater Los Angeles VA Healthcare Center, Los Angeles, California; and ‡‡Department of Ophthalmology, Kaiser Permanente, Woodland Hills, California.
Dome-shaped macula (DSM) can cause serous macular detachment. A radial optical coherence tomography (OCT) scan aids diagnosis, with treatments like aflibercept or photodynamic therapy showing positive outcomes.
Area of Science:
- Ophthalmology
- Medical Imaging
- Retinal Diseases
Background:
- Dome-shaped macula (DSM) is a recognized anatomical variation.
- Serous macular detachment (SMD) can be associated with DSM, potentially impacting vision.
- Accurate diagnosis is crucial for effective management of SMD in DSM.
Observation:
- This study presents two cases of DSM with associated SMD.
- Radial optical coherence tomography (OCT) scanning enhanced visualization of the dome-shaped macular bulge.
- En face OCT angiography revealed changes in choroidal vessel caliber post-treatment.
Findings:
- Radial OCT scanning protocol improved the detection of DSM as a cause of SMD.
- Both intravitreal aflibercept and half-fluence photodynamic therapy were effective in resolving subretinal fluid.
- Treatment led to a reduction in choroidal vessel caliber, visualized with en face OCT angiography.
Implications:
- Radial OCT scanning should be considered for diagnosing suspected DSM, particularly in myopic eyes with subretinal fluid.
- Intravitreal aflibercept and photodynamic therapy are viable treatment options for SMD secondary to DSM.
- Understanding the role of choroidal vasculature in DSM-related SMD may inform future therapeutic strategies.
