The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes

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 Nav...

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Autores principales:	Damasceno NA, Damasceno EF, Yannuzzi NA, Crane AM, Relhan N, Smiddy WE, Flynn HW Jr
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	foveal tractional lesions idiopathic epiretinal membranes central foveal bouquet clinical outcomes surgical outcomes Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/120f43c90b3340068e1d3f4d52ba07a6
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spelling	oai:doaj.org-article:120f43c90b3340068e1d3f4d52ba07a62021-12-02T08:36:56ZThe Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes1177-5483https://doaj.org/article/120f43c90b3340068e1d3f4d52ba07a62020-08-01T00:00:00Zhttps://www.dovepress.com/the-central-subfoveal-bouquet-in-idiopathic-epiretinal-membranes-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Nadyr 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 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.Keywords: foveal tractional lesions; idiopathic epiretinal membrane lesions; central foveal bouquet; clinical outcomes; surgical outcomes,Damasceno NADamasceno EFYannuzzi NACrane AMRelhan NSmiddy WEFlynn HW JrDove Medical Pressarticlefoveal tractional lesions idiopathic epiretinal membranescentral foveal bouquetclinical outcomessurgical outcomesOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 2353-2359 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	foveal tractional lesions idiopathic epiretinal membranes central foveal bouquet clinical outcomes surgical outcomes Ophthalmology RE1-994
spellingShingle	foveal tractional lesions idiopathic epiretinal membranes central foveal bouquet clinical outcomes surgical outcomes Ophthalmology RE1-994 Damasceno NA Damasceno EF Yannuzzi NA Crane AM Relhan N Smiddy WE Flynn HW Jr The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes
description	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 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.Keywords: foveal tractional lesions; idiopathic epiretinal membrane lesions; central foveal bouquet; clinical outcomes; surgical outcomes,
format	article
author	Damasceno NA Damasceno EF Yannuzzi NA Crane AM Relhan N Smiddy WE Flynn HW Jr
author_facet	Damasceno NA Damasceno EF Yannuzzi NA Crane AM Relhan N Smiddy WE Flynn HW Jr
author_sort	Damasceno NA
title	The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes
title_short	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_sort	central subfoveal bouquet in idiopathic epiretinal membranes
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/120f43c90b3340068e1d3f4d52ba07a6
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The Central Subfoveal Bouquet in Idiopathic Epiretinal Membranes

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