{
    "abstract": "To characterize the clinical and multimodal imaging features of central bouquet hemorrhage (CBH) with Henle fiber layer (HFL) involvement in highly myopic eyes, and to investigate the relationships between hemorrhage characteristics, reabsorption time, and visual outcomes.\nMulticenter, retrospective analysis of highly myopic eyes with CBH involving the HFL, confirmed by optical coherence tomography (OCT).\nEighteen eyes from 18 subjects were included for analysis. The mean age of the cohort was 39 \u00b1 13.7 years (range: 17-69) and 61% of subjects were female. Mean refractive error was -14.8 \u00b1 3.14 diopters (range: -9 D to -22 D). All eyes demonstrated a combined CBH with HFL component, while a subretinal component was present in 83.3% of cases. Myopic choroidal neovascularization (CNV) was excluded in all eyes using optical coherence tomography angiography (OCTA) or dye-based angiography (fluorescein or indocyanine green). No correlation was observed between hemorrhage size and visual outcomes or reabsorption time. Hemorrhage cleared after a mean of 2.63 months, and the radial HFL hemorrhage component resolved first. All eyes showed improvement in visual acuity from baseline. Persistent OCT alternations after resolution of hemorrhage included ellipsoid zone disruption (88.9%) and hyperreflective changes in HFL (77.8%). Anti-VEGF injections were administered to 6 eyes (33.3%) and did not correlate with a significant visual or anatomical benefit.\nCBH with HFL involvement in high myopia was associated with significantly improved visual outcomes from baseline but structural alterations can persist after clinical resolution. The size of the hemorrhage did not correlate with resorption time, and anti-VEGF treatment did not affect outcome. These findings provide new insights into the natural history and management of nonneovascular CBH in highly myopic eyes.",
    "authors": [
        {
            "affiliation": "Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel; Stein Eye Institute, University of California-Los Angeles School of Medicine, Los Angeles, CA, United States. Electronic address: mirifoglevin@gmail.com.",
            "firstname": "Meira Fogel",
            "initials": "MF",
            "lastname": "Levin"
        },
        {
            "affiliation": "Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.",
            "firstname": "Giuseppe",
            "initials": "G",
            "lastname": "Querques"
        },
        {
            "affiliation": "Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy.",
            "firstname": "Riccardo",
            "initials": "R",
            "lastname": "Sacconi"
        },
        {
            "affiliation": "Kellogg Eye Center, University of Michigan, Ann Arbor, MI, United States.",
            "firstname": "Jason M L",
            "initials": "JML",
            "lastname": "Miller"
        },
        {
            "affiliation": "Kellogg Eye Center, University of Michigan, Ann Arbor, MI, United States.",
            "firstname": "Mark W",
            "initials": "MW",
            "lastname": "Johnson"
        },
        {
            "affiliation": "Department of Ophthalmology, Hospital Intercommunal de Creteil, University Paris Est Creteil, Creteil, France.",
            "firstname": "Alexandra",
            "initials": "A",
            "lastname": "Miere"
        },
        {
            "affiliation": "Department of Ophthalmology, Hospital Intercommunal de Creteil, University Paris Est Creteil, Creteil, France.",
            "firstname": "Eric",
            "initials": "E",
            "lastname": "Souied"
        },
        {
            "affiliation": "Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, United States.",
            "firstname": "Anne",
            "initials": "A",
            "lastname": "Kunkler"
        },
        {
            "affiliation": "Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, United States.",
            "firstname": "Nicolas A",
            "initials": "NA",
            "lastname": "Yannuzzi"
        },
        {
            "affiliation": "Western and Central Clinical Schools, Discipline of Ophthalmology and Eye Health, The University of Sydney, Sydney, Australia; Department of Ophthalmology, Faculty of Medicine, Health and Human Sciences, Macquarie University Hospital, Sydney, Australia.",
            "firstname": "Adrian T",
            "initials": "AT",
            "lastname": "Fung"
        },
        {
            "affiliation": "Vitreous Retina Macula Consultants of New York, NY, United States; Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY, United States.",
            "firstname": "K Bailey",
            "initials": "KB",
            "lastname": "Freund"
        },
        {
            "affiliation": "Vitreous Retina Macula Consultants of New York, NY, United States.",
            "firstname": "Tommaso",
            "initials": "T",
            "lastname": "Bacci"
        },
        {
            "affiliation": "Vitreous Retina Macula Consultants of New York, NY, United States; Department of Ophthalmology, Hospital Nord, Aix-Marseille University, Chemin des Bourrely, Marseille, France.",
            "firstname": "Prithvi",
            "initials": "P",
            "lastname": "Ramtohul"
        },
        {
            "affiliation": "Vitreous Retina Macula Consultants of New York, NY, United States.",
            "firstname": "Lawrence",
            "initials": "L",
            "lastname": "Yannuzzi"
        },
        {
            "affiliation": "Doheny Eye Institute, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, United States.",
            "firstname": "SriniVas R",
            "initials": "SR",
            "lastname": "Sadda"
        },
        {
            "affiliation": "Department of Ophthalmology, New England Eye Center, Tufts University, Boston, MA, United States.",
            "firstname": "Caroline R",
            "initials": "CR",
            "lastname": "Baumal"
        },
        {
            "affiliation": "Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.",
            "firstname": "Panos",
            "initials": "P",
            "lastname": "Christakis"
        },
        {
            "affiliation": "Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada.",
            "firstname": "R Rishi",
            "initials": "RR",
            "lastname": "Gupta"
        },
        {
            "affiliation": "Stein Eye Institute, University of California-Los Angeles School of Medicine, Los Angeles, CA, United States.",
            "firstname": "Michael",
            "initials": "M",
            "lastname": "Ip"
        },
        {
            "affiliation": "Stein Eye Institute, University of California-Los Angeles School of Medicine, Los Angeles, CA, United States.",
            "firstname": "Ahmad",
            "initials": "A",
            "lastname": "Santina"
        },
        {
            "affiliation": "Stein Eye Institute, University of California-Los Angeles School of Medicine, Los Angeles, CA, United States.",
            "firstname": "Adrian",
            "initials": "A",
            "lastname": "Au"
        },
        {
            "affiliation": "Stein Eye Institute, University of California-Los Angeles School of Medicine, Los Angeles, CA, United States; Greater Los Angeles VA Healthcare Center, Los Angeles, CA, United States.",
            "firstname": "David",
            "initials": "D",
            "lastname": "Sarraf"
        }
    ],
    "conclusions": "CBH with HFL involvement in high myopia was associated with significantly improved visual outcomes from baseline but structural alterations can persist after clinical resolution. The size of the hemorrhage did not correlate with resorption time, and anti-VEGF treatment did not affect outcome. These findings provide new insights into the natural history and management of nonneovascular CBH in highly myopic eyes.",
    "copyrights": "Copyright \u00a9 2025 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.jcjo.2025.03.019",
    "journal": "Canadian journal of ophthalmology. Journal canadien d'ophtalmologie",
    "keywords": [],
    "methods": null,
    "publication_date": "2025-04-28",
    "pubmed_id": "40288421",
    "results": "Eighteen eyes from 18 subjects were included for analysis. The mean age of the cohort was 39 \u00b1 13.7 years (range: 17-69) and 61% of subjects were female. Mean refractive error was -14.8 \u00b1 3.14 diopters (range: -9 D to -22 D). All eyes demonstrated a combined CBH with HFL component, while a subretinal component was present in 83.3% of cases. Myopic choroidal neovascularization (CNV) was excluded in all eyes using optical coherence tomography angiography (OCTA) or dye-based angiography (fluorescein or indocyanine green). No correlation was observed between hemorrhage size and visual outcomes or reabsorption time. Hemorrhage cleared after a mean of 2.63 months, and the radial HFL hemorrhage component resolved first. All eyes showed improvement in visual acuity from baseline. Persistent OCT alternations after resolution of hemorrhage included ellipsoid zone disruption (88.9%) and hyperreflective changes in HFL (77.8%). Anti-VEGF injections were administered to 6 eyes (33.3%) and did not correlate with a significant visual or anatomical benefit.",
    "title": "Central bouquet hemorrhage with Henle fiber layer extension in myopic eyes.",
    "xml": "<Element 'PubmedArticle' at 0x788505313560>"
}