Dome-shaped macula in children and adolescents

Abstract

We sought to evaluate the incidence and characteristics of dome-shaped macula (DSM) in children and adolescents with myopia. Methods A retrospective review of medical records was performed to identify subjects who were younger than 19 years with myopia of −3.0 diopters or greater. The results of optical coherence tomography images were analyzed to identify DSM. The height and diameter of the dome were measured. Age, best-corrected visual acuity (BCVA), and refractive error of study participants who exhibited DSM were compared with those of patients who did not. Results Among the 1,042 eyes of 615 patients, eight eyes (0.77%) of seven patients had DSM. Six of these eight eyes were not highly myopic (i.e., less than −6.0 diopters of spherical equivalents). Additionally, the mean height and diameter of the identified domes were 146.50 ± 42.33 μm and 4779.75 ± 699.38 μm, respectively. Patients with DSM were significantly older (mean age: 15.88 ± 2.36 years) than patients without it (11.51 ± 4.60 years; p = 0.007). The youngest affected patient was 11 years old. There was no significant difference in refractive errors (p = 0.629) or BCVA (p = 0.314) between the two groups. Conclusions Although the incidence in this study was very low, DSM was found even in children and adolescents. In addition, 75% of affected individuals were not highly myopic. These results suggest that inherent traits may be involved in development of DSM.

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

“… 22 In fact, staphylomas are known to develop in middle age, 4 , 16 , 20 whereas DSM can be present very early in life. 2 , 3 , 4 , 5 In keeping with this, it is of note that the DSM studies in children and adolescents 2 , 3 , 4 , 5 do not report the existence of staphylomas. The absence of staphyloma in our patient may be readily explained by her age.…”

“…Interestingly, most of the aforementioned studies only used fundoscopy and standard OCT or colour images. 3 , 8 , 9 , 10 , 12 , 13 , 14 , 15 , 24 , 25 Therefore, the prevalence of DSM in conjunction with staphyloma found in these studies would likely be different if other imaging methods had been applied. In addition, posterior elongation of the sclera secondary to pathologic myopia has been confused with posterior staphyloma in some OCT studies.…”

“… 12 , 15 , 16 , 18 , 21 There are other studies, on the contrary, which do not report the association of DSM with posterior staphyloma. 3 , 4 , 5 , 8 , 12 , 22 The diagnosis of staphyloma is commonly based on fundoscopy, colour images or OCT scans. However, the accuracy of these methods for diagnosing staphylomas remains controversial.…”

“…Dome-shaped macula (DSM) was first described by Gaucher et al in 2008 as a convex elevation of the macula within a myopic staphyloma. 1 Since then, there has been an increasing number of studies describing DSM, mainly in adults with high myopia, but also in children and adolescents 2 , 3 , 4 , 5 ; and both in patients with emmetropia and hypermetropia. 6 Although Gaucher et al defined the condition as a macular bulge within a myopic staphyloma, DSM has been frequently observed in the absence of a staphyloma.…”

“… 17 , 18 Interestingly, studies conducted in children only found horizontal dome shapes in their cohorts. 2 , 3 , 4 , 5 …”