Visual Acuity and Size of Choroidal Neovascularization in Highly Myopic Eyes with a Dome-Shaped Macula

Introduction. A dome-shaped macula (DSM) is an inward convexity or anterior deviation of the macular area. DSM is believed as a protective factor in maintaining visual acuity in highly myopic eyes. Objective. To investigate the correlation between best-corrected visual acuity (BCVA), choroidal neova...

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Main Authors: Lu Wang, Bin-wu Lin, Xiao-fang Yin, Wei-lan Huang, Yi-zhi Wang, Long Pang
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2020/8852156
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author Lu Wang
Bin-wu Lin
Xiao-fang Yin
Wei-lan Huang
Yi-zhi Wang
Long Pang
author_facet Lu Wang
Bin-wu Lin
Xiao-fang Yin
Wei-lan Huang
Yi-zhi Wang
Long Pang
author_sort Lu Wang
collection DOAJ
description Introduction. A dome-shaped macula (DSM) is an inward convexity or anterior deviation of the macular area. DSM is believed as a protective factor in maintaining visual acuity in highly myopic eyes. Objective. To investigate the correlation between best-corrected visual acuity (BCVA), choroidal neovascularization (CNV), and a dome-shaped macula (DSM) in highly myopic eyes. Methods. In this retrospective and observational case series study, BCVA tests and optical coherence tomography (OCT) were performed in a total of 472 highly myopic eyes (refractive error ≥6.5 diopters or axial length ≥26.5 mm). CNV was detected by fundus fluorescein angiography (FFA), and the CNV area was measured by ImageJ software. BCVA, central retinal thickness (CRT), and the CNV area were compared between highly myopic eyes with and without DSM. Results. The data revealed 13 eyes with DSM complicated by CNV, for an estimated prevalence of 25%. The eyes with CNV in the DSM group showed worse BCVA than those in the non-DSM group (1.59 ± 0.69 and 0.63 ± 0.64, respectively, p<0.05), and the CNV area in the DSM group was larger than that in the non-DSM group (2793.91 ± 2181.24 and 1250.71 ± 1210.36 pixels, respectively, p<0.05). After excluding the eyes with CNV, the DSM group had better BCVA than the non-DSM group (0.33 ± 0.17 and 0.44 ± 0.48, respectively, p<0.05); however, no significant difference was observed in the CRT of eyes with CNV between the DSM group and the non-DSM group. Conclusion. These results show that DSM might be a protective mechanism for visual acuity, but its protective capability is limited. DSM eyes have better visual acuity within the protective capability. If a more powerful pathogenic factor exceeding the protective capability is present, then the eye will have more severe CNV and worse visual acuity.
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spelling doaj-art-cafce78d0d5c4df490d4a80eced6480a2025-08-20T03:24:04ZengWileyJournal of Ophthalmology2090-004X2090-00582020-01-01202010.1155/2020/88521568852156Visual Acuity and Size of Choroidal Neovascularization in Highly Myopic Eyes with a Dome-Shaped MaculaLu Wang0Bin-wu Lin1Xiao-fang Yin2Wei-lan Huang3Yi-zhi Wang4Long Pang5Department of Ophthalmology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510000, ChinaDepartment of Ophthalmology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510000, ChinaDepartment of Ophthalmology, Foshan Hospital Affiliated to Southern Medical University, The Second People’s Hospital of Foshan, Foshan 528000, ChinaPhysical Examination Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510000, ChinaGuangzhou University of Chinese Medicine, Guangzhou 510405, ChinaDepartment of Ophthalmology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510000, ChinaIntroduction. A dome-shaped macula (DSM) is an inward convexity or anterior deviation of the macular area. DSM is believed as a protective factor in maintaining visual acuity in highly myopic eyes. Objective. To investigate the correlation between best-corrected visual acuity (BCVA), choroidal neovascularization (CNV), and a dome-shaped macula (DSM) in highly myopic eyes. Methods. In this retrospective and observational case series study, BCVA tests and optical coherence tomography (OCT) were performed in a total of 472 highly myopic eyes (refractive error ≥6.5 diopters or axial length ≥26.5 mm). CNV was detected by fundus fluorescein angiography (FFA), and the CNV area was measured by ImageJ software. BCVA, central retinal thickness (CRT), and the CNV area were compared between highly myopic eyes with and without DSM. Results. The data revealed 13 eyes with DSM complicated by CNV, for an estimated prevalence of 25%. The eyes with CNV in the DSM group showed worse BCVA than those in the non-DSM group (1.59 ± 0.69 and 0.63 ± 0.64, respectively, p<0.05), and the CNV area in the DSM group was larger than that in the non-DSM group (2793.91 ± 2181.24 and 1250.71 ± 1210.36 pixels, respectively, p<0.05). After excluding the eyes with CNV, the DSM group had better BCVA than the non-DSM group (0.33 ± 0.17 and 0.44 ± 0.48, respectively, p<0.05); however, no significant difference was observed in the CRT of eyes with CNV between the DSM group and the non-DSM group. Conclusion. These results show that DSM might be a protective mechanism for visual acuity, but its protective capability is limited. DSM eyes have better visual acuity within the protective capability. If a more powerful pathogenic factor exceeding the protective capability is present, then the eye will have more severe CNV and worse visual acuity.http://dx.doi.org/10.1155/2020/8852156
spellingShingle Lu Wang
Bin-wu Lin
Xiao-fang Yin
Wei-lan Huang
Yi-zhi Wang
Long Pang
Visual Acuity and Size of Choroidal Neovascularization in Highly Myopic Eyes with a Dome-Shaped Macula
Journal of Ophthalmology
title Visual Acuity and Size of Choroidal Neovascularization in Highly Myopic Eyes with a Dome-Shaped Macula
title_full Visual Acuity and Size of Choroidal Neovascularization in Highly Myopic Eyes with a Dome-Shaped Macula
title_fullStr Visual Acuity and Size of Choroidal Neovascularization in Highly Myopic Eyes with a Dome-Shaped Macula
title_full_unstemmed Visual Acuity and Size of Choroidal Neovascularization in Highly Myopic Eyes with a Dome-Shaped Macula
title_short Visual Acuity and Size of Choroidal Neovascularization in Highly Myopic Eyes with a Dome-Shaped Macula
title_sort visual acuity and size of choroidal neovascularization in highly myopic eyes with a dome shaped macula
url http://dx.doi.org/10.1155/2020/8852156
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