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The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes

PURPOSE: To report both the unoperated clinical course and the surgical outcomes of eyes with a central foveal bouquet (CB) secondary to idiopathic epiretinal membranes (iERMs). DESIGN: Retrospective, consecutive, and observational case series. METHODS: All patients examined between January 1, 2014,...

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Autores principales: Damasceno, Nadyr A, Damasceno, Eduardo F, Yannuzzi, Nicolas A, Crane, Ashley M, Relhan, Nidhi, Smiddy, William E, Flynn, Harry W
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493214/
https://www.ncbi.nlm.nih.gov/pubmed/32982149
http://dx.doi.org/10.2147/OPTH.S254544
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author Damasceno, Nadyr A
Damasceno, Eduardo F
Yannuzzi, Nicolas A
Crane, Ashley M
Relhan, Nidhi
Smiddy, William E
Flynn, Harry W
author_facet Damasceno, Nadyr A
Damasceno, Eduardo F
Yannuzzi, Nicolas A
Crane, Ashley M
Relhan, Nidhi
Smiddy, William E
Flynn, Harry W
author_sort Damasceno, Nadyr A
collection PubMed
description PURPOSE: To report both the unoperated clinical course and the surgical outcomes of eyes with a central foveal bouquet (CB) secondary to idiopathic epiretinal membranes (iERMs). DESIGN: Retrospective, consecutive, and observational case series. METHODS: All patients examined between January 1, 2014, and December 31, 2019, for evaluation of epiretinal membrane with a CB lesion identified on spectral domain optical coherence tomography (SD-OCT) were included. Exclusion criteria included vitreoretinal comorbidities associated with secondary ERMs and an absence of CB lesions on SD-OCT. Patients were divided into two groups: those who were followed with observation (Group I) and those who received surgery (Group II). Each group had 3 different types of mechanical abnormalities of the CB previously described as cotton ball sign, subfoveal detachment, or acquired vitelliform lesion, without a subanalysis discrimination. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA) at baseline and last follow-up, subjective metamorphopsia, central retinal thickness (CMT), mechanical stress lesions of the CB, and resolution or evolution of the CB lesions during the follow-up interval. RESULTS: Two hundred seventy-six eyes with iERM were reviewed, and 46 eyes met the inclusion criteria. Among these, 21 of 46 (46%) were observed, and 25 of 46 (54%) underwent surgery. Metamorphopsia was identified in 61.9% of patients in Group I and 81.2% of patients in Group II, at baseline. The mean BCVA was 0.19 ± 0.17 (20/30) in Group I and 0.31 ± 0.33 (20/40) in Group II at presentation. At the final exam, patients in Group I achieved a mean BCVA of 0.24 ± 0.18 (20/30), while patients in Group II obtained a mean BCVA of 0.15 ± 0.21 (20/30). Spontaneous resolution of the CB sign occurred in 5 of 21 eyes (23.8%) that were observed, whereas, after surgery, the CB sign resolved in 16 of 25 eyes (61.5%). Mean CMT was 422 ± 84.2μm in Group I and 531 ± 143.9μm in Group II, at baseline, while at the latest follow-up, the mean CMT was 400 ± 40.8μm in the cases followed with observation and 454 ± 148.7μm in the surgical cases. CONCLUSION: The clinical course and surgical outcomes of CB findings in iERM are favorable in terms of visual acuity. However, those receiving surgery had an increase in visual acuity and resolution of the CB abnormality.
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spelling pubmed-74932142020-09-24 The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes Damasceno, Nadyr A Damasceno, Eduardo F Yannuzzi, Nicolas A Crane, Ashley M Relhan, Nidhi Smiddy, William E Flynn, Harry W Clin Ophthalmol Original Research PURPOSE: To report both the unoperated clinical course and the surgical outcomes of eyes with a central foveal bouquet (CB) secondary to idiopathic epiretinal membranes (iERMs). DESIGN: Retrospective, consecutive, and observational case series. METHODS: All patients examined between January 1, 2014, and December 31, 2019, for evaluation of epiretinal membrane with a CB lesion identified on spectral domain optical coherence tomography (SD-OCT) were included. Exclusion criteria included vitreoretinal comorbidities associated with secondary ERMs and an absence of CB lesions on SD-OCT. Patients were divided into two groups: those who were followed with observation (Group I) and those who received surgery (Group II). Each group had 3 different types of mechanical abnormalities of the CB previously described as cotton ball sign, subfoveal detachment, or acquired vitelliform lesion, without a subanalysis discrimination. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA) at baseline and last follow-up, subjective metamorphopsia, central retinal thickness (CMT), mechanical stress lesions of the CB, and resolution or evolution of the CB lesions during the follow-up interval. RESULTS: Two hundred seventy-six eyes with iERM were reviewed, and 46 eyes met the inclusion criteria. Among these, 21 of 46 (46%) were observed, and 25 of 46 (54%) underwent surgery. Metamorphopsia was identified in 61.9% of patients in Group I and 81.2% of patients in Group II, at baseline. The mean BCVA was 0.19 ± 0.17 (20/30) in Group I and 0.31 ± 0.33 (20/40) in Group II at presentation. At the final exam, patients in Group I achieved a mean BCVA of 0.24 ± 0.18 (20/30), while patients in Group II obtained a mean BCVA of 0.15 ± 0.21 (20/30). Spontaneous resolution of the CB sign occurred in 5 of 21 eyes (23.8%) that were observed, whereas, after surgery, the CB sign resolved in 16 of 25 eyes (61.5%). Mean CMT was 422 ± 84.2μm in Group I and 531 ± 143.9μm in Group II, at baseline, while at the latest follow-up, the mean CMT was 400 ± 40.8μm in the cases followed with observation and 454 ± 148.7μm in the surgical cases. CONCLUSION: The clinical course and surgical outcomes of CB findings in iERM are favorable in terms of visual acuity. However, those receiving surgery had an increase in visual acuity and resolution of the CB abnormality. Dove 2020-08-17 /pmc/articles/PMC7493214/ /pubmed/32982149 http://dx.doi.org/10.2147/OPTH.S254544 Text en © 2020 Damasceno et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Damasceno, Nadyr A
Damasceno, Eduardo F
Yannuzzi, Nicolas A
Crane, Ashley M
Relhan, Nidhi
Smiddy, William E
Flynn, Harry W
The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes
title The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes
title_full The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes
title_fullStr The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes
title_full_unstemmed The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes
title_short The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes
title_sort central subfoveal bouquet in idiopathic epiretinal membranes
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493214/
https://www.ncbi.nlm.nih.gov/pubmed/32982149
http://dx.doi.org/10.2147/OPTH.S254544
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