Macular Bruch's membrane defect and dome-shaped macula in high myopia

Area of Science:

• Ophthalmology
• Retinal Imaging
• Myopia Research

Background:

• Dome-shaped macula (DSM) and macular Bruch's membrane defects (MBMD) are conditions observed in highly myopic eyes.
• Understanding the relationship between these findings is crucial for diagnosing and managing high myopia complications.

Purpose of the Study:

• To investigate the association between the presence of macular Bruch's membrane defects (MBMD) and a dome-shaped appearance of the macula (DSM) in highly myopic individuals.

Main Methods:

• A retrospective, observational case series study was conducted.
• Swept-source optical coherence tomography (OCT) was used to visualize DSM and MBMDs in highly myopic eyes.
• MBMDs were defined as defects within Bruch's membrane within 1500 μm of the foveola.

Main Results:

• Out of 1983 highly myopic eyes, 8.4% exhibited DSM, and 534 eyes showed MBMD.
• A significant association was found between the prevalence of DSM and MBMD (OR: 1.96; P<0.001), even after adjusting for axial length.
• Eyes with DSM and MBMD showed specific patterns of retinal, RPE, and choroidal changes, with three types of MBMDs associated with DSM identified.

Conclusions:

• The presence of a dome-shaped macula (DSM) is significantly associated with macular Bruch's membrane defects (MBMD).
• The observed morphology suggests that focal relaxation of the posterior sclera may contribute to DSM formation when not supported by an expanding Bruch's membrane.