THE ROLE OF OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN DOME-SHAPED MACULOPATHY

The aim of this study was to demonstrate the role of optical coherence tomography angiography in the management of dome-shaped maculopathy.

This was a retrospective case review.

A 52-year-old woman was referred to the authors' retinal service for potential bilateral choroidal neovascular membrane (CNVM) and blurry vision bilaterally. Initial spectacle-corrected visual acuity was 20/30-2 in the right eye and 20/30 + 2 in the left eye. Dome-shaped maculopathy was diagnosed on optical coherence tomography. In both eyes, optical coherence tomography B-scan passing through the fovea showed shallow irregular retinal pigment epithelium elevation suspicious of occult (type 1) CNVM. The outer retinal and choriocapillaris angiograms showed a zone of nonexudative CNVM in the right eye and exudative CNVM in the left eye. Given the persistent subretinal fluid with CNVM in the left eye, the authors elected to perform intravitreal injections of ranibizumab 0.5 mg on a treat and extend regimen. On the most recent follow-up, the best-corrected visual acuity improved to 20/20 in the left eye with no persisting subretinal fluid.

The authors present a case where assessing disease progression and the development of CNVM and evaluating the efficiency of therapies were realized through the application of novel optical coherence tomography angiography technology. This diagnostic tool may be used to guide clinicians in their management of dome-shaped maculopathy, as demonstrated through the authors' experience. Optical coherence tomography angiography can also make it possible to visualize nonexudative CNVM lesions that may be missed on traditional imaging assessments.