Long-term clinical outcomes of dome-shaped macula: a contralateral eye comparison

To assess the long-term clinical and anatomical characteristics of eyes with dome-shaped macula (DSM) through a contralateral eye comparison in patients with unilateral involvement.

This retrospective observational study included 33 highly myopic patients with unilateral DSM. Eyes with DSM (Group 1) were compared with contralateral eyes without DSM (Group 2). All patients were followed for at least three years. Uncorrected and best-corrected visual acuity (UCVA and BCVA), refractive parameters, axial length (AL), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), complications, and applied treatments were analysed.

UCVA was significantly better in Group 1 than in Group 2 at both presentation and the 3-year follow-up (p = 0.01 and p = 0.03, respectively). Spherical equivalent was significantly lower in Group 1 at both time points (p = 0.03 and p = 0.02, respectively). AL was shorter in Group 1 than in Group 2, although the difference was not significant; however, axial elongation over time was greater in Group 2. CMT and SFCT were significantly higher in Group 1 at presentation and follow-up. Subretinal fluid was present in 21 eyes in Group 1 at presentation. During follow-up, myopic macular neovascularisation developed in 4 eyes in Group 1 and 2 eyes in Group 2, without a significant intergroup difference.

Eyes with DSM demonstrate distinct refractive and anatomical features, including lower spherical equivalent, relatively shorter AL, and increased CMT and SFCT. Subretinal fluid is a common finding, while no significant association was found between DSM and myopic macular neovascularisation.