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Dome-shaped macula: a potential protective factor for visual acuity after cataract surgery in patients with high myopia
  1. Xiangjia Zhu1,2,3,4,
  2. Wenwen He1,2,3,4,
  3. Shaohua Zhang1,2,3,4,
  4. Xianfang Rong1,2,3,4,
  5. Qi Fan1,2,3,4,
  6. Yi Lu1,2,3,4
  1. 1Department of Ophthalmology, Eye and Ear, Nose, Throat Hospital, Fudan University, Shanghai, People’s Republic of China
  2. 2Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai, People’s Republic of China
  3. 3NHC Key Laboratory of Myopia, Fudan University, Shanghai, People’s Republic of China
  4. 4Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, People’s Republic of China
  1. Correspondence to Dr Yi Lu, Eye Institute, Eye and Ear, Nose, and Throat Hospital, Fudan University, Shanghai 200031, People’s Republic of China; luyieent{at}


Purpose To evaluate whether the presence of dome-shaped macula (DSM) is a protective factor for visual acuity after cataract surgery in patients with high myopia.

Methods Included were 891 highly myopic cataract eyes (600 patients) that were examined by optical coherence tomography (OCT) through the central fovea and underwent cataract surgery in our hospital. DSM was defined as an inward bulge >50 µm in horizontal or vertical OCT sections. The incidences of various maculopathies were compared between eyes with and those without DSM. The influences of age, sex, eye laterality, axial length and DSM on postoperative visual acuity were evaluated by multivariate linear regression.

Results Of the 891 eyes, 123 (13.8%) had DSM. There was a greater association of DSM with extrafoveal retinoschisis (RS) than with other vision-threatening complications such as foveal RS and choroidal neovascularisation. In addition to axial length and age, sex was associated with the presence of DSM (p=0.016). In bilateral high myopia, the incidence of DSM increased with the degree of anisometropia and was more common in the longer eye of patients with anisometropia. Younger age, male sex, shorter axial length and the presence of DSM were associated with better postoperative visual acuity in highly myopic cataract eyes (β=0.124, p=0.002; β=0.142, p<0.001; β=0.275, p<0.001 and β=−0.088, p=0.038, respectively).

Conclusion Associated with fewer visual threatening macular complications, presence of DSM may be a protective factor for visual function after cataract surgery in highly myopic eyes.

  • dome-shaped macula
  • high myopia
  • cataract surgery
  • visual function

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  • XZ and WH contributed equally.

  • Contributors XZ designed the study. WH, SZ, XR and QF performed the study. SZ and WH

    performed data collection and management. XZ, WH and SZ performed data analysis and interpretation. XZ and YL wrote and reviewed the manuscript. All authors have approved the manuscript.

  • Funding This article was supported by research grants from the National Natural Science Foundation of the People’s Republic of China (grant nos. 81870642, 81470613, 81100653, 81670835 and 81270989), the Shanghai High Myopia Study Group, the Shanghai Talent Development Fund (grant no. 201604) and the Outstanding Youth Medical Talents Program of Shanghai Health and Family Planning Commission (grant no. 2017YQ011).

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data sharing statement All data will be made available on request.

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