Ayurvedic management of Dome-shaped maculopathy: A case report

Abstract

Dome-Shaped Maculopathy (DSM) is a rare condition characterized by the anterior convex elevation of the macula toward the vitreous cavity. Due to a lack of available data about DSM, the exact cause is not known. In Ayurveda, analysis of DSM can be done on the basis of the predominance of aggravated Dosha (~regulatory functional factors of the body) and their specific Gunas (~properties). This condition can be taken as a result of the vitiation of all three Doshas with the dominancy of Vata. Timira (~one of the diseases causing visual disturbance) is one of the Drishtigata roga (~ eyesight disorders). A 31-year-old female presented to the Shalakya tantra outpatient department with blurred vision in her left eye and headache that had persisted for four years. On the basis of the optical coherence tomography, she was diagnosed with DSM along with subretinal fluid. Ama pachana (~enhancing digestion), Vatanulomana (~pacification of obstructed Vata), Tridosha shamaka (~reducing alleviated regulating functional factors), Rasayana (~rejuvenation therapy), and Shothahara chikitsa (~anti-inflammatory) were adopted in the management that was focused in reducing the subretinal fluid and preventing further complications such as retinal detachment. In this case, subretinal fluid was decreased after Virechana karma, but the level of subretinal fluid was noticed again after Tarpana. The visual acuity was improved from 6/24 to 6/12 in the left eye and was maintained after one month of follow-up and the complaint of headache was also resolved. The patient in this case was nonmyopic with dome-shaped macula and subretinal fluid and with Ayurvedic intervention; the subretinal fluid was lessened, resulting in an improvement in visual acuity.