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Francesco Viola, Laura Dell'Arti, Eleonora Benatti, Chiara Mapelli, Giulio Barteselli, Monica Serafini, Roberto Ratiglia; Morphologic Choroidal Changes in Dome Shaped Macula Combining Indocyanine Green Angiography (ICGA) and Spectral Domain Optical Coherence Tomography (SD-OCT). Invest. Ophthalmol. Vis. Sci. 2013;54(15):2792.
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© ARVO (1962-2015); The Authors (2016-present)
To describe macular choroidal changes in dome shaped macula using ICGA and SD-OCT and to elucidate the mechanism of serous retinal detachment formation and its course.
We retrospectively studied the medical records of patients with dome shaped macula. All patients had undergone simultaneous fluorescein angiography (FA), ICGA and SD-OCT using confocal laser scanning system (Spectralis, Heidelberg Engineering, Heidelberg, Germany). Enhanced-depth imaging (EDI) OCT was used to examine the choroidal changes.
Thirteen patients (23 eyes) with dome shaped macula were included. The median refractive error was -10.5 diopters [D] (range -0.50 to -28 D) and the median axial length was 27.8 mm (range 23.64 - 32.14 mm). The best corrected visual acuity ranged from 0.16 to 1.0 (median 0.57). The mean subfoveal choroidal thickness was 117.43 μm ± 58.65. Two eyes (8.7%) showed choroidal neovascularization on FA and ICGA. Seven eyes (30.4%) showed subfoveal fluid (SFF) by OCT. Among these patients, focal points of leakage (FPL) on FA were associated with SFF in 6 eyes (p<0.01; Pearson’s correlation). Seven eyes (30.4%) showed mid-phase ICGA punctate hyperfluorescent spots (IPHS). In 6 out of the 7 eyes with IPHS, this finding was associated with SFF (p<0.01; Pearson’s correlation). All the 7 patients with SFF were followed-up for at least 6 months (range 6-36 months). During the follow-up, in one eye SFF spontaneously resolved with FPL and IPHS disappearance. In a patient that at baseline had unilateral SFF, at 1 year follow-up, SFF formation occurred in the fellow eye with concomitant appearance of FPL and IPHS. In the other cases SFF showed a variable fluctuating course.
Patients with dome shaped macula and SFF showed punctate hyperfluorescent spots on mid-phase ICGA, miming central serous chorioretinopathy (CSCR). Nevertheless other peculiarities of CSCR such as increased choroidal thickness and choroidal vascular hyperpermeability were not indisputably seen in our patients. Notably typical retinal findings in dome shaped maculopathy appear similar to those described in inferior posterior staphyloma as well. Further studies are needed to elucidate the role played by the choroid in the development of SFF in these diseases.
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