April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Neuroretinal Detachment in Dome Shaped Syndrome
Angelo M. Minnella; Cristina Maria Savastano; Benedetto Falsini; Giacomilde Mazzone; Matteo Federici; Mariangela Gari; Lucilla Barbano; Carmela Grazia Caputo; Emilio Balestrazzi
Author Affiliations & Notes
  • Angelo M. Minnella
    Ophthalmology, Catholic University, Rome, Italy
  • Cristina Maria Savastano
    Ophthalmology, Catholic University, Rome, Italy
  • Benedetto Falsini
    Ophthalmology, Catholic University, Rome, Italy
  • Giacomilde Mazzone
    Ophthalmology, Catholic University, Rome, Italy
  • Matteo Federici
    Ophthalmology, Catholic University, Rome, Italy
  • Mariangela Gari
    Ophthalmology, Catholic University, Rome, Italy
  • Lucilla Barbano
    Ophthalmology, Catholic University, Rome, Italy
  • Carmela Grazia Caputo
    Ophthalmology, Catholic University, Rome, Italy
  • Emilio Balestrazzi
    Ophthalmology, Catholic University, Rome, Italy
  • Footnotes
    Commercial Relationships  Angelo M. Minnella, None; Cristina Maria Savastano, None; Benedetto Falsini, None; Giacomilde Mazzone, None; Matteo Federici, None; Mariangela Gari, None; Lucilla Barbano, None; Carmela Grazia Caputo, None; Emilio Balestrazzi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 2179. doi:
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      Angelo M. Minnella, Cristina Maria Savastano, Benedetto Falsini, Giacomilde Mazzone, Matteo Federici, Mariangela Gari, Lucilla Barbano, Carmela Grazia Caputo, Emilio Balestrazzi; Neuroretinal Detachment in Dome Shaped Syndrome. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2179.

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Abstract

Purpose: : To evaluate the possible etiopathogenesis of foveal neuroretinal detachment in dome shaped macula.

Methods: : In the observational period of 18 months, we recruited five eyes of three patients (Female: Male=2:1) with mean age of 56.4 (SD±2.3) years. Inclusion criteria were: no media opacity, maximum antero-posterior axial length not superior of 26 mm, dome shaped macula with foveal neuroretinal detachment. Exclusion criteria were: vitreoretinal traction detectable of the SD-OCT, macular oedema, ocular tumors, and previous inflammatory diseases. All patients underwent complete ophthalmoscopic examination including best corrected visual acuity (BCVA), fundus biomicroscopy, axial length measurement, spectral domain-optical coherence tomography (SD-OCT) analysis; fluorescein angiography (FA) and indocyanine angiography (ICA) evaluations, B-scan ultrasonography and microperimetry-MP1 assessments.

Results: : All eyes received 2 photodynamic therapy (PDT) treatments and 3 anti-Vascular Endothelium Growth Factor (anti-VEGF) injections. No morpho-functional changes were observed throughout the follow-up. At the end of follow-up a mean VA reduction from 24.8 (±4) to 22.2 (±2) ETDRS letters was recorded. Ultrasonography showed scleral curvature changes with pronounced convex appearance only at posterior pole. FA and ICA confirmed the absence of neovascular or other inflammatory diseases. SD-OCT showed the bulge formed of the macula: "dome shaped", with an abnormal adhesion of the photoreceptor outer segments with retinal pigment epithelium. Microperimetry analysis showed a mean sensitivity reduction from baseline (6.84 dB ±1.4) to 18 months (6.4 dB ±1.4).

Conclusions: : We observed no response to different therapeutic procedures in eyes with subretinal fluid related to "dome shaped". The reason for this failure remains unclear. However, the SD-OCT results suggest that an abnormal mechanical adhesion of photoreceptors tip with RPE cells, with twist and cell separation, is a major underlying pathologic mechanism of the disease.

Keywords: degenerations/dystrophies • imaging/image analysis: clinical • photoreceptors 
© 2011, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2024 Association for Research in Vision and Ophthalmology.
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