A case of polypoidal choroidal vasculopathy and serous retinal detachment in a bilateral dome-shaped macula

Purpose: To report a case of polypoidal choroidal vasculopathy in the right eye which improved after intravitreal injection of anti-vascular endothelial growth factor, and serous retinal detachment (SRD) in the left eye which improved spontaneously in a patient with a bilateral dome-shaped macula (DSM) with a tilted optic disc and inferonasal posterior staphyloma. Case summary: A 50-year-old female visited our clinic with visual disturbance of the right eye for 5 days. A tilted optic disc with inferonasal posterior staphyloma and DSM were observed in both eyes by fundus examination and spectral domain optical coherence tomography (SD-OCT), and there was no specific finding in the left eye, but pigment epithelial detachment (PED) with subretinal hemorrhage was observed in the right eye. Polyps and branching vascular networks were found using indocyanine green angiography. We performed intravitreal C3F8 gas and aflibercept injection. After 3 months, SD-OCT of the right eye showed no subretinal hemorrhage and diminished PED. SD-OCT of the left eye showed SRD but the SRD disappeared after 1 month. SD-OCT of the left eye showed no recurrence of the SRD. Conclusions: In a patient with a tilted optic disc and dome-shaped macula, polypoidal choroidal vasculopathy and SRD may occur, so appropriate treatment will be necessary.