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Long-term natural history of highly myopic eyes with a dome-shaped macula with or without untreated serous retinal detachment: a 4-year follow-up study
  1. Francesco Viola1,2,
  2. Gaia Leone1,
  3. Elena Garoli1,
  4. Claudia Mainetti2,
  5. Davide Galli2,
  6. Alessandro Invernizzi3
  1. 1 University of Milan, Milan, Italy, Milano, Italy
  2. 2 Ophthalmological Unit, Ca’ Granda IRCCS Foundation- Maggiore Policlinico Hospital, Milan, Italy
  3. 3 Eye Clinic, Department of Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy
  1. Correspondence to Francesco Viola, Department of Clinical Science and Community Health, University of Milan, Italy, Milan 20100, Italy; francesco.viola{at}


Purpose To evaluate the long-term functional and morphological changes occurring in myopic eyes with a dome-shaped macula (DSM), with or without untreated serous retinal detachment (SRD).

Methods This prospective, single-centre study enrolled consecutive cases of highly myopic patients with DSM with or without a SRD. Patients underwent complete ophthalmological examinations, optical coherence tomography, axial length measurements and autofluorescence. Follow-up visits were performed with a maximum interval of 6 months for 4 years. Eyes with choroidal neovascularisation were excluded.

Results Twenty-six eyes from 18 patients (mean age 61.2) were included. At baseline, 13 eyes had SRD and 13 did not. The DSMs were either horizontal (69%) or round (31%). There were no significant differences in best-corrected visual acuity (BCVA) between eyes with and without SRD during the 48-month follow-up period. Multivariate analysis showed that baseline BCVA was the only parameter among those analysed (age and SRD height) to have a significant effect on the final BCVA (p<0.0001). SRD fluctuated overtime and SRD height was significantly influenced by choroidal thickness (p=0.002). The scleral bulge thickness had no effect on SRD thickness.

Conclusions BCVA remained clinically stable over 4 years without treatment despite the fluctuations and persistence of the SRDs.

  • Macula
  • Retina
  • Vision
  • Imaging

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval Data collection was approved by the institutional review board (IRB) of Granda IRCCS Foundation-Maggiore Policlinico Hospital. A waiver of informed consent was granted by the IRB for this observational analysis. Ethics approval ID not required. IRB of our institution followed Italian law for clinical studies, which does not require a formal approval for observational studies. Written informed consent was obtained from all subjects before taking part in accordance with our institutional guidelines. This study adhered to the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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