Aim To analyse the choroidal thickness (CT) and vessel pattern of myopic patients with dome-shaped macula (DSM) and their association with the DSM axis and serous retinal detachment (SRD).

Methods Retrospective study. The CT and vessel pattern were assessed on optical coherence tomography (OCT), OCT-angiography and ultra-wide-field photography.

Results 27 eyes of 18 subjects (mean age: 65 years) were included. Compared with the 11 eyes (41%) with horizontal DSM, the 16 eyes (59%) with vertical DSM had a shorter axial length (25.8±2 mm vs 28.3±2.5 mm; p=0.01), a higher mean macular bulge height (624.4±207 µm vs 255.4±160.3 µm; p=0.0001) and a thicker CT (183.1±91.1 µm vs 72±38.3 µm; p<0.001). Large choroidal vessels crossed the macular area in 75% of eyes with vertical DSM vs 27% of eyes with horizontal DSM (p=0.02), whereas a watershed zone framing the macula was more often seen in horizontal DSM (72% vs 25%, p=0.02). Thirteen eyes (48%) had an SRD that was not associated with the DSM axis, the mean bulge height, the CT or the vessel pattern.

Conclusion The presence of an SRD did not correlate with the DSM axis, the CT or the vessel pattern. However, the rate of large choroidal vessels crossing the macula was higher in vertical DSM than in horizontal DSM.