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Y. Imamura, T. Iida, S. A. Zweifel, I. Maruko, T. Fujiwara, R. F. Spaide; Dome-Shaped Macula: Scleral Imaging Using Enhanced Depth Imaging Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2010;51(13):339.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the scleral structure in patients with dome-shaped macula, a relatively common condition defined as convex elevation of the macula as compared with the surrounding staphylomatous region in highly myopic eyes.
Patients with dome-shaped macula underwent enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT), which was obtained by positioning a spectral domain OCT device close enough to the eye to acquire an inverted image. Seven sections each comprised of 100 averaged scans were obtained within a 5x 30 rectangle to encompass the macula. The subfoveal scleral thickness was measured from the outer border of the choroid to the outer scleral border at multiple points in the posterior pole.
EDI-OCT showed a localized and convex-shaped scleral thickening under the macular region in eyes with the dome-shaped macular configuration. The subfoveal scleral thickness, measured in 23 eyes of 15 myopic patients with dome-shaped macula, was 527 µm (standard deviation 157 µm). The submacular scleral thickness measured in 23 eyes of 14 myopic eyes with staphyloma but without dome-shaped macula was 291 µm (standard deviation 81 µm). The difference in the submacular scleral thickness was highly significant (P<0.001). The scleral thickness outside of the macular region was not different between the two groups.
Dome-shaped macula is associated with a localized thickening of the sclera under the macula in highly myopic patients. Scleral imaging with EDI-OCT can provide valuable information to elucidate the mechanistic events underlying the pathologic scleral changes in staphyloma, in particular the structural configuration accounting for dome-shaped macula.
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