Dome-Shaped Macula Curvature: A New Quantitative Metric to Assess Dome-Shaped Macula Subtypes

Purpose: To test a new quantitative metric focused on the evaluation of dome-shaped macula curvature (DSMC); to assess its clinical role in evaluating round (R-DSM), vertical (V-DSM), and horizontal (H-DSM) DSM types; and to examine its relationships with other ocular parameters. Methods: Patients affected by DSM secondary to high myopia were included in this cross-sectional, observational case study. DSMC was calculated by measuring the base (chord length) and height (distance from the chord to the apex) of the DSM. These measurements were used to determine the radius (R) of the hypothetical circle representing the curvature of the DSM. Curvature (K) was then calculated as the reciprocal of R. In addition, we measured choroidal thickness (CT), best-corrected visual acuity (BCVA), and spherical equivalent (SE) to assess its potential relationship with DSMC. Results: A total of 125 eyes from 107 patients (25 males, 23%) were included, with a mean age of 65.67 ± 13.51 years. DSM subtypes—categorized as 57 R-DSM eyes (45.6%), 58 H-DSM eyes (46.4%), and 10 V-DSM eyes (8%)—showed significantly different DSMC (P = 0.039), with R-DSM showing the highest DSMC values. Conversely, V-DSM and H-DSM were characterized by similar DSMC. Subfoveal CT showed a strong inverse correlation with DSMC (P < 0.0001; r = −0.60), with a consistent reduction in CT as curvature increased. DSMC was also significantly associated with SE, with higher DSMC values corresponding to greater myopic refractive errors (P = 0.009; r = −0.21). Conclusions: DSMC may be considered a reliable and reproducible quantitative metric to analyze DSM subtypes. The association of DSMC with CT highlights the influence of scleral curvature on choroidal morphology and trophism, paving the way for future new outcome measures. Translational Relevance: DSMC provides an objective and reproducible method to evaluate DSM morphology across subtypes (round, vertical, and horizontal). By quantifying curvature through OCT-based parameters, this metric enables standardized comparisons and enhances the clinical characterization of DSM. Furthermore, the study provides insights into the disease mechanisms by uncovering significant associations between DSMC and choroidal thickness.