圆顶状黄斑与屈光状态的关系及常见并发症

The relationship between dome-shaped macula and refractive state and common complications

圆顶状黄斑(dome-shaped macula,DSM)在OCT上表现为黄斑部视网膜脉络膜向内隆起。其发病机制目前尚未完全明确,主要认为与局部巩膜增厚的适应性代偿有关。DSM可发生于近视、正视或远视眼,在高度屈光不正的患者中更为常见,在高度近视人群中患病率约为10%~20%。DSM的常见并发症有浆液性视网膜脱离、脉络膜新生血管、视网膜劈裂、黄斑裂孔、黄斑前膜等,目前对于DSM与并发症的出现是伴随关系还是因果关系有待进一步确认。无症状的DSM需随访观察,若出现并发症并明显损害视功能时,可采用抗血管内皮生长因子、光凝、光动力疗法或手术等方法治疗。

Dome-shaped macula(DSM)shows an inward bulge of the retina and choroid in the macula area on optical coherence tomography.The exact pathogenesis of DSM remains unclear,but it is primarily associated with adaptive compensation due to localized sclera thickening.DSM exists in patients with myopia,emmetropia or hypermetropia,and is more frequently observed in patients with high ametropia.The prevalence rate is about 10%~20%among high myopia people.Common complications of DSM include serous retinal detachment,choroidal neovascularization,retinoschisis,macular hole and macular epiretinal membrane,etc.Currently,it needs to be further confirmed that whether DSM is a concomitant or a causal relationship with the occurrence of complications.For asymptomatic DSM,regular follow-up observation is recommended.If complications occur and significantly impair visual function,methods such as anti-vascular endothelial growth factor,photocoagulation,photodynamic therapy or manual therapy can be used.