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[Dome-shaped macula: features of differential diagnostics with clinical examples]
M V Melikhova1, M V Gatsu2, E V Boiko2
1Saint Petersburg branch of S. Fyodorov Eye Microsurgery Federal State Institution, 21 Yaroslava Gasheka St., St. Petersburg, Russian Federation, 192283.
Vestnik Oftalmologii
|June 29, 2018
Summary
Dome-shaped macula (DSM) can be mistaken for choroidal hemangioma (HC). Enhanced depth imaging optical coherence tomography (EDI-OCT) is key for differentiating these conditions, with FA and MRI useful in complex cases.
Area of Science:
- Ophthalmology
- Medical Imaging
Background:
- Dome-shaped macula (DSM) is characterized by posterior pole protrusion due to scleral thickening.
- DSM can present with complications like serous retinal detachment (SRD), mimicking choroidal hemangioma (HC).
- Accurate differentiation is crucial for appropriate patient management.
Purpose of the Study:
- To illustrate differential diagnostic capabilities for DSM versus HC using advanced imaging.
Main Methods:
- Two clinical cases of DSM with HC were examined.
- Diagnostic tools included enhanced depth imaging optical coherence tomography (EDI-OCT), OCT angiography, fluorescent angiography (FA), indocyanine-green angiography (ICG), and MRI.
Main Results:
- EDI-OCT is the primary, highly informative method for differentiating DSM and HC.
- FA and MRI are recommended for challenging differential diagnoses.
- OCT angiography and ICG angiography aid in identifying the cause of SRD in DSM.
Conclusions:
- Low awareness of DSM contributes to diagnostic difficulties.
- Ophthalmoscopy alone is often insufficient for DSM detection.
- Utilizing EDI-OCT, FA, and MRI, with correct interpretation, can prevent diagnostic errors.
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