The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes
The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes
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Nadyr A Damasceno,1,2 Eduardo F Damasceno,1,3 Nicolas A Yannuzzi,1 Ashley M Crane,1 Nidhi Relhan,1 William E Smiddy,1 Harry W Flynn Jr1 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Ophthalmology, Hospital Naval Marcilio Dias, Rio de Janeiro, RJ, Brazil; 3Department of Ophthalmology, Universidade Federal Fluminense, Niteroi, RJ, BrazilCorrespondence: Harry W Flynn JrBascom Palmer Eye Institute, 900 N.W.17th Street, Miami, FL 33136, USATel +1 305-243-2020Email HFlynn@med.
miami.eduPurpose: 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 BAKING SODA 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 Accessories:Car Parts:Other Car Parts acuity.However, those receiving surgery had an increase in visual acuity and resolution of the CB abnormality.
Keywords: foveal tractional lesions; idiopathic epiretinal membrane lesions; central foveal bouquet; clinical outcomes; surgical outcomes,.