Dome-shaped macula with protrusion of inner part of sclera

PURPOSE: To report our findings in a patient with a two layered dome shaped macula (DSM) in which only the inner layer of the sclera protruded anteriorly. OBSERVATIONS: An 84-year-old woman with high myopia had a DSM in both eyes. The optical coherence tomographic (OCT) image of the left eye showed a uniform thickening of the foveal sclera, but the DSM of the right eye was split into an inner and outer layer by intrascleral blood vessels running between the two layers. OCT showed that only the inner layer of the sclera protruded anteriorly while the outer layer remained in its normal position. CONCLUSIONS AND IMPORTANCE: The two layered DSM suggests that the etiology of DSMs may be more complex.