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Francesca Guidolin, Elisabetta Pilotto, Enrica Convento, Alessandra Bruno, Evelyn Longhin, Edoardo Midena; Morphological and functional evaluation of dome-shaped maculopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4951.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate retinal sensitivity impairment in dome-shaped maculopathy (DSM) and to correlate it to optical coherence tomography (OCT) features.
All referred patients with DSM were consecutively studied by means of enhanced depth imaging spectral-domain OCT (EDI-OCT). Two linear scans centered into the fovea, horizontally and vertically, were acquired. Subfoveal retinal thickness, bulge height and choroidal thickness were measured by two independent graders. The presence of foveal subretinal fluid (fSRF), extrafoveal subretinal fluid (eSRF), pigment epithelium detachment (PED), subretinal pigment and macular schisis were also evaluated. Retinal sensitivity and fixation were studied by means of both mesopic and scotopic microperimetry. Fixation quantification was analyzed using Bivariate Contour Ellipse Area (BCEA).
Seven patients with bilateral DSM were studied (14 eyes). DSM was horizontal in 10 eyes (71.42%), vertical in 2 eyes (14.29%) and symmetric in 2 (14.29%). Inter-grader agreement was excellent (ICC> 0.98). Subfoveal retinal thickness was 169.57 ± 64.29 µm, and subfoveal choroidal thickness was 203.57 ± 69.52 µm. Choroid was thicker inferiorly compared to all the other sites (vs superior, p=0.0049; vs nasal, p=0.0002; vs temporal, p=0.0076). Subfoveal retinal thickness was positively related to retinal sensitivity (rho=0.7193), and inversely related to BCEA (rho=-0.4526). The presence of fSRF (8/14 eyes, 66.67%), was not related to bulge height (OR = 1). Both fSRF and bulge height were inversely related to retinal sensitivity, both in mesopic (p=0.0338 and rho=-0.5790, respectively) and scotopic microperimetry (p=0.1005 and rho=-0.5874, respectively). The presence of PED (5/14 eyes, 41.67%) significantly determined fixation instability (p=0.045).
Morphological OCT features, that characterize DSM, correlate with retinal dysfunction. The anomalous topographic distribution of choroidal thickness may suggest a role of choroid in the pathogenesis of DSM.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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