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Jonas JB, Panda-Jonas S, Wei WB, Xu J, Wang YX. Prevalence and associations of dome-shaped maculas. The Beijing Eye Study. Acta Ophthalmol 2024. [PMID: 39340175 DOI: 10.1111/aos.16764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Accepted: 09/14/2024] [Indexed: 09/30/2024]
Abstract
PURPOSE To explore the prevalence and associated factors of a dome-shaped macula (DSM) in a general population. METHODS Out of the population-based Beijing Eye Study cohort (n = 3468 participants), the investigation included all eyes with an axial length of ≥25 mm, and a randomized sample of eyes with an axial length of <25 mm. Using optical coherence tomographic (OCT) images, we examined presence and height of DSMs, defined as an inward convexity of the foveal retinal pigment epithelium (RPE)/Bruch's membrane (BM) line, detectable in at least two OCT scans perpendicularly orientated to each other. RESULTS The study cohort consisted of 366 eyes (314 individuals) with a mean age of 63.7 ± 9.7 years and a mean axial length of 24.8 ± 2.1 mm (median: 25.1 mm; range: 18.96-30.88 mm). Prevalence of DSMs (found in 6/366 eyes; 1.9%; 95%CI: 1.0, 3.0) increased from 0/125 (0%) in non-myopic eyes to 1/152 (0.7%; 95%CI: 0.0, 2.0) in moderately myopic eyes, and to 6/83 (7.2%; 95%CI: 1.7, 12.7) in the highly myopic group. In multivariable analysis, higher DSM prevalence corelated with longer axial length (OR: 2.05; 95%CI: 1.36, 3.08; p < 0.001) and higher stage of myopic macular degeneration (OR: 1.08; 95%CI: 1.01, 1.16; p = 0.03). The mean maximal DSM height was 139 ± 107 μm (median: 100 μm; range: 25-350 μm). It was associated with higher stage of myopic macular degeneration (beta: 0.24; p < 0.001) and higher prevalence of macular BM defects (beta: 0.17; p < 0.001). None of the DSMs showed a serous retinal detachment or relative choroidal thickening. CONCLUSIONS Higher DSM prevalence correlated non-linearly with longer axial length, with DSM height increasing with the presence of a BM defect. DSMs may be associated with an axial elongation-related BM overproduction in the fundus midperiphery in all meridians.
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Affiliation(s)
- Jost B Jonas
- Rothschild Foundation Hospital, Institut Français de Myopie, Paris, France
- Singapore Eye Research Institute, Singapore, Singapore
- Privatpraxis Prof Jonas und Dr. Panda-Jonas, Heidelberg, Germany
- New York Eye and Ear Infirmary of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Beijing Visual Science and Translational Eye Research Institute (BERI), Beijing Tsinghua Changgung Hospital, Tsinghua Medicine, Tsinghua University, Beijing, China
| | - Songhomitra Panda-Jonas
- Privatpraxis Prof Jonas und Dr. Panda-Jonas, Heidelberg, Germany
- Department of Ophthalmology, Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Wen-Bin Wei
- Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology and Visual Sciences Key Laboratory, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jie Xu
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ya Xing Wang
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Zhang Y, Qin X, Zhang L, Chen C, Wu M, Li Y. The features of dome-shape Macula and related complications in high myopia on optical coherence tomography. Eur J Ophthalmol 2024; 34:1569-1575. [PMID: 38327073 DOI: 10.1177/11206721241232029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
PURPOSE This study used optical coherence tomography scanning and 3D reconstruction of the macular region in high myopia to examine more thoroughly and carefully the differences between high myopia-related macular complications with and without dome-shape macula (DSM) and to determine whether the DSM's fine structure has an effect on them. METHODS Retrospective analysis of the medical records of 345 eyes with high myopia who underwent an optical coherence tomography (OCT) examination. They were divided into the DSM group (69 eyes) and the group without DSM (276 eyes). Macular complications between the two groups were compared. The height of the DSM and the diameter of the dome base were measured. And then the association between DSM type, protrusion height and macular problems were analyzed. RESULTS Epiretinal membrane (ERM) and extrafoveal schisis occurred more frequently in the DSM group, but the was no statistically significant difference in the frequency of foveal schisis between the two groups. The majority of eyes in the DSM categorization had a horizontal oval-shaped domain. In the DSM group, there was no evident difference in the percentage of eyes with macular complications in the groups below 150 um and above 150 um. CONCLUSIONS OCT examination-based fine macular structure analysis reveals that DSM affects various macular problems in distinct ways. DSM could increase the risk of extrafoveal schisis and ERM while decreasing the risk of foveal schisis. The height of the DSM had no obvious impact on the prevalence of macular complications.
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Affiliation(s)
- Yanyan Zhang
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, China
| | - Xiuhong Qin
- Department of Ophthalmology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Linyi Zhang
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, China
| | - Chunhong Chen
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, China
| | - Meng Wu
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, China
| | - Yanzhen Li
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, China
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Cohen SY, Vignal-Clermont C, Trinh L, Ohno-Matsui K. Tilted disc syndrome (TDS): New hypotheses for posterior segment complications and their implications in other retinal diseases. Prog Retin Eye Res 2021; 88:101020. [PMID: 34800679 DOI: 10.1016/j.preteyeres.2021.101020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
Tilted disc syndrome (TDS) is considered a congenital anomaly due to a delayed closure of the embryonic fissure. It is characterized by an oblique orientation of the axis of the optic disc, associated with other posterior pole anomalies such as inferior crescent, situs inversus and inferior staphyloma. The aim of this review was to summarize the data supporting the current hypotheses for the pathogenesis of TDS, and its anatomical and functional clinical consequences. Recent imaging techniques, such as magnetic resonance imaging, wide-field fundus imaging, and 2- and 3-D optical coherence tomography have provided a new perspective on TDS and its complications. Different abnormalities have previously been reported, both in the anterior and posterior segments. The focus was on vision-threatening chorioretinal changes or complications, including choroidal neovascularization and serous retinal detachments and their therapeutic options. Based on clinical observations, assumptions were proposed to understand the occurrence of complications such as chorioretinal degenerative changes, choroidal neovascularization and polypoidal choroidal vasculopathy, macular serous retinal detachment, myopic foveoschisis and chorioretinal folds. These hypotheses could be referred to as the curvature "breaking point" hypothesis, the uneven growth "tractional" hypothesis, the "container-content" imbalance hypothesis, and the "choroidal funnel" hypothesis. Because these complications could also occur in other contexts, understanding the pathogenesis of TDS complications could help to understand their pathophysiology.
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Affiliation(s)
- Salomon Yves Cohen
- Ophthalmic Center of Imaging and Laser, Paris, France; Department of Ophthalmology, Intercity Hospital and University of Paris Est, Creteil, France.
| | | | - Liem Trinh
- CHNO des Quinze-Vingts, IHU Foresight, INSERM-DGOS CIC 1423, Paris, France
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
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Negrier P, Couturier A, Gaucher D, Touhami S, Le Guern G, Tadayoni R, Gaudric A, Philippakis E. Choroidal thickness and vessel pattern in myopic eyes with dome-shaped macula. Br J Ophthalmol 2021; 106:1730-1735. [PMID: 34183323 DOI: 10.1136/bjophthalmol-2021-319066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/05/2021] [Indexed: 11/03/2022]
Abstract
AIM To analyse the choroidal thickness (CT) and vessel pattern of myopic patients with dome-shaped macula (DSM) and their association with the DSM axis and serous retinal detachment (SRD). METHODS Retrospective study. The CT and vessel pattern were assessed on optical coherence tomography (OCT), OCT-angiography and ultra-wide-field photography. RESULTS 27 eyes of 18 subjects (mean age: 65 years) were included. Compared with the 11 eyes (41%) with horizontal DSM, the 16 eyes (59%) with vertical DSM had a shorter axial length (25.8±2 mm vs 28.3±2.5 mm; p=0.01), a higher mean macular bulge height (624.4±207 µm vs 255.4±160.3 µm; p=0.0001) and a thicker CT (183.1±91.1 µm vs 72±38.3 µm; p<0.001). Large choroidal vessels crossed the macular area in 75% of eyes with vertical DSM vs 27% of eyes with horizontal DSM (p=0.02), whereas a watershed zone framing the macula was more often seen in horizontal DSM (72% vs 25%, p=0.02). Thirteen eyes (48%) had an SRD that was not associated with the DSM axis, the mean bulge height, the CT or the vessel pattern. CONCLUSION The presence of an SRD did not correlate with the DSM axis, the CT or the vessel pattern. However, the rate of large choroidal vessels crossing the macula was higher in vertical DSM than in horizontal DSM.
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Affiliation(s)
- Pierre Negrier
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
| | - Aude Couturier
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
| | - David Gaucher
- Ophtalmology, University Hospitals Strasbourg, Strasbourg, Alsace, France
| | - Sara Touhami
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
| | - Guillaume Le Guern
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
| | - Ramin Tadayoni
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
| | - Alain Gaudric
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
| | - Elise Philippakis
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
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Ohno-Matsui K, Wu PC, Yamashiro K, Vutipongsatorn K, Fang Y, Cheung CMG, Lai TYY, Ikuno Y, Cohen SY, Gaudric A, Jonas JB. IMI Pathologic Myopia. Invest Ophthalmol Vis Sci 2021; 62:5. [PMID: 33909033 PMCID: PMC8083114 DOI: 10.1167/iovs.62.5.5] [Citation(s) in RCA: 126] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Pathologic myopia is a major cause of visual impairment worldwide. Pathologic myopia is distinctly different from high myopia. High myopia is a high degree of myopic refractive error, whereas pathologic myopia is defined by a presence of typical complications in the fundus (posterior staphyloma or myopic maculopathy equal to or more serious than diffuse choroidal atrophy). Pathologic myopia often occurs in eyes with high myopia, however its complications especially posterior staphyloma can also occur in eyes without high myopia. Owing to a recent advance in ocular imaging, an objective and accurate diagnosis of pathologic myopia has become possible. Especially, optical coherence tomography has revealed novel lesions like dome-shaped macula and myopic traction maculopathy. Wide-field optical coherence tomography has succeeded in visualizing the entire extent of large staphylomas. The effectiveness of new therapies for complications have been shown, such as anti-VEGF therapies for myopic macular neovascularization and vitreoretinal surgery for myopic traction maculopathy. Myopia, especially childhood myopia, has been increasing rapidly in the world. In parallel with an increase in myopia, the prevalence of high myopia has also been increasing. However, it remains unclear whether or not pathologic myopia will increase in parallel with an increase of myopia itself. In addition, it has remained unclear whether genes responsible for pathologic myopia are the same as those for myopia in general, or whether pathologic myopia is genetically different from other myopia.
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Affiliation(s)
- Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Pei-Chang Wu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kenji Yamashiro
- Department of Ophthalmology and Visual Sciences, University Graduate School of Medicine, Kyoto, Japan.,Department of Ophthalmology, Otsu Red-Cross Hospital, Otsu, Japan
| | | | - Yuxin Fang
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Timothy Y Y Lai
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong
| | - Yasushi Ikuno
- Ikuno Eye Center, 2-9-10-3F Juso-Higashi, Yodogawa-Ku, Osaka 532-0023, Japan.,Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Ophthalmology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Salomon Yves Cohen
- Centre Ophtalmologique d'Imagerie et de Laser, Paris, France.,Department of Ophthalmology and University Paris Est, Creteil, France
| | - Alain Gaudric
- Department of Ophthalmology, APHP, Hôpital Lariboisière and Université de Paris, Paris, France.,Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Dome-shaped macula-Review of literature. Surv Ophthalmol 2020; 66:560-571. [PMID: 33245953 DOI: 10.1016/j.survophthal.2020.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 11/23/2022]
Abstract
Dome-shaped macula is a convex retinochoroidal elevation within the region of a posterior staphyloma seen commonly in high myopia on optical coherence tomography. With growing awareness of the condition facilitated by inclusion of optical coherence tomography in routine retinal practice, coupled with evolution of enhanced depth optical coherence tomography imaging, multiple studies have attempted to shed light on pathogenesis of this complex pathology, its clinical implications, and treatment of associated complications such as serous macular detachment and choroidal neovascularization with variable success. Our review aims to assimilate, scrutinize, and discuss the available literature for a comprehensive insight into dome-shaped macula.
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Martin-Gutierrez MP, Georgiou M, Michaelides M. Subfoveal retinal detachment associated with dome-shaped macula in a 6 year-old child: Comparison with other case reports and systematic review of the literature regarding dome-shaped macula in children. Am J Ophthalmol Case Rep 2020; 19:100821. [PMID: 32743121 PMCID: PMC7387773 DOI: 10.1016/j.ajoc.2020.100821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/16/2020] [Accepted: 07/04/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose To describe the case of an asymptomatic 6-year-old girl, who was found to have bilateral dome-shaped macula, associated with left serous macular detachment and left optic disc pit, and no evidence of posterior staphyloma in either eye, and to review the literature regarding dome-shaped macula in children and compare our patient's findings with similar case reports. Observations Our patient presented with bilateral dome-shaped macula and several other accompanying features, already described in previous reports in children her age. Conclusions and importance Dome-shaped macula is a relatively new entity, which has been mainly described in highly myopic adults. Since its description, an increasing number of studies have been published to help characterise this condition and to elucidate its nature, causes, epidemiology and associated findings. Although the majority of the available data relate to adults, there are a number of studies that describe dome-shaped macula in children and adolescents. In this paper, we discuss the association of dome-shaped macula in children with posterior staphyloma, myopia, and suggest a possible developmental aetiology for this entity.
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