Epiretinal Membrane in Dome-Shaped Macula Complicated with Serous Retinal Detachment: Transient Efficacy of Surgery

Abstract

Dome-shaped macula (DSM) is an entity recently described as a convex anterior protrusion of the macular area within a posterior myopic staphyloma. Specific complications were associated with DSM, like serous retinal detachment (SRD). We describe a woman presenting with a decreased vision at 20/50. SD-OCT scans were performed, showing a macular bulge. SRD was present and an epiretinal membrane could also be observed. Fluorescein angiography and indocyanin green angiography did not show any leakage nor choroidal neovascularization. Epiretinal membrane peeling was performed, and 3 months after surgery, SRD completely disappeared. However, SRD reappeared 1 year after surgery and enlarged within 2 years following surgery. In conclusion, two mechanisms could be considered for physiopathology of SRD: first, the epiretinal membrane may have exerted traction on the macular retina, second, vitreous body might constitute a tank for cytokines and/or other factors, triggering subretinal fluid accumulation, leading to SRD.

IMI Pathologic Myopia

“… 246 A transient improvement has been observed after surgery for epiretinal membrane. 247 However, all studies were case reports or small series and no comparison with a control group was performed. To date, no effective treatment is available for SRF complicating dome-shaped macula.…”

Macular Hole Surgery in Dome-Shaped Maculopathy

“…5 Attempts to treat this with various interventions including laser, diuretics, anti-inflammatory drops and even surgery have met with variable success. [7][8][9][10][11][12][13] Recently, we encountered a case of dome-shaped maculopathy associated with macular hole formation. A standard approach of surgery including vitrectomy, internal limiting membrane (ILM) peeling with triamcinolone acetate visualization, and gas tamponade was successful.…”