Abstract: As a progressive pathological condition, dome-shaped macula (DSM) is characterized by an inward convexity or bulge of the retinal pigment epithelium in the macular region, with the bulge height over than 50  μm, which occurs mostly in patients with high myopia. The pathogenesis of DSM development remains unclear; several hypotheses have been suggested, such as tangential vitreoretinal traction, localized thickening of sclera and choroid in the macular area, and macular Bruch’s membrane defect. DSM is often accompanied by serous retinal detachment, choroidal neovascularization, macular splits and other complications, thus increasing the risk of visual impairment. Clinically, asymptomatic patients with DSM mainly take regular follow-up observation. When serous retinal detachment and significant visual impairment appear, treatment with half-dose photodynamic therapy, supplementary of laser photocoagulation or oral mineral corticoid receptor antagonists may have a beneficial effect. However, more large clinical studies are required to confirm the exact efficacy of these treatments. Optical coherence tomography (OCT) and related fundus image examinations provide objective evidences for clinical diagnosis. OCT can visually display the inward bulge of the macula and other changes associated with it. (Int Rev Ophthalmol, 2023, 47: 131-137)

Key words: dome-shaped macula, high myopia, macular /pathophysiology