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Perifoveal exudative vascular anomalous complex (PEVAC)
Complejo anómalo vascular exudativo perifoveal (PEVAC)
M. Sotomayor-Toribio
, F. López-Herrero, J.L. Sánchez-Vicente, B. González-Jáuregui, C. Rodríguez-Fernández, J. Suárez-Pérez
Corresponding author
Departamento de Oftalmología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Note the 4 × 2 mm full-thickness inferior paracentral stromal necrotic tissue. B) Intraoperative microscopic view of the multilayered amniotic membrane (AM) patch sutured to the corneal stroma adjacent to the defect with 10-0 nylon loose stitches. C) Early postoperative anterior segment optical coherence tomography view of full-thickness defect repair using multilayer patch and AM graft with therapeutic contact lens.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Montejano-Milner, J.V. Dabad-Moreno, A. de la Hoz-Polo, A. Boto de los Bueis" "autores" => array:4 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Montejano-Milner" ] 1 => array:2 [ "nombre" => "J.V." "apellidos" => "Dabad-Moreno" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "de la Hoz-Polo" ] 3 => array:2 [ "nombre" => "A." 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Hyper-reflective material can be seen above the ILM and occupation of the macular hole defect with homogeneous hyper-reflective material with disruption of the outer retinal layers. (B) OCT 6 months after macular hole repair surgery, there is a recovery of the ultrastructure of the foveal area.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "N. Ruiz del Rio, F. Garcí Ibor, D. Hernandez Perez, A.M. Duch Samper" "autores" => array:4 [ 0 => array:2 [ "nombre" => "N." "apellidos" => "Ruiz del Rio" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Garcí Ibor" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Hernandez Perez" ] 3 => array:2 [ "nombre" => "A.M." 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Sotomayor-Toribio, F. López-Herrero, J.L. Sánchez-Vicente, B. González-Jáuregui, C. Rodríguez-Fernández, J. Suárez-Pérez" "autores" => array:6 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Sotomayor-Toribio" "email" => array:1 [ 0 => "malena.sotomayortoribio@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "F." "apellidos" => "López-Herrero" ] 2 => array:2 [ "nombre" => "J.L." "apellidos" => "Sánchez-Vicente" ] 3 => array:2 [ "nombre" => "B." "apellidos" => "González-Jáuregui" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Rodríguez-Fernández" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Suárez-Pérez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Departamento de Oftalmología, Hospital Universitario Virgen del Rocío, Sevilla, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Complejo anómalo vascular exudativo perifoveal (PEVAC)" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1836 "Ancho" => 2540 "Tamanyo" => 309016 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">OCT, angio-OCT, En-face and fluorescein angiography of the left eye of case 3. (A) Macular OCT of the left eye: shows hard exudates and microaneurysmal lesion marked with red arrow. (B) Angio-OCT and en face: hyperreflective spot in deep plexus. (C) FAG: microaneurysm in posterior pole, marked with red arrow, with minimal paramacular exudative component at late times, with no signs of peripheral ischemia. (D) Colour fundus photograph of the left eye.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Perifoveal exudative vascular anomalous complex (PEVAC) is a unilateral, isolated, perifoveal aneurysmal anomaly first described by Querques et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> in 2011. It is defined as an aneurysmal lesion in the perifoveal region accompanied by active exudation and intraretinal cysts in patients without associated vascular or inflammatory pathology.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Initially described as an isolated lesion, cases of multiple and bilateral lesions have recently been reported.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In addition, cases have been described in patients with age-related macular degeneration (AMD),<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,4</span></a> myopia,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> pachychoroidopathy or macular hole.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> It has also been reported in patients with arterial hypertension or diabetes without associated retinopathy.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,7,8</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">PEVACs could be the consequence of a degenerative process of the retinal vascular endothelium in patients without other retinal vascular pathologies. This would explain the lack of response to anti-VEGF treatment.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> On optical coherence tomography (OCT), PEVACs appear as rounded intraretinal hyporeflective structures,<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> usually associated with cystic changes, corresponding to intraretinal fluid. There are also non-exudative forms, corresponding to subclinical stages.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Fluorescein angiography (FAG) shows a hyperfluorescent lesion with variable diffusion. Indocyanine green (ICG) shows no diffusion. Tomographic angiography (OCTA) shows a flow signal corresponding to aneurysmal dilatation.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">We present three patients with PEVAC, two of them diabetic without associated retinopathy. The third patient was initially diagnosed with AMD, without associated neovascularisation.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Clinical cases</span><p id="par0025" class="elsevierStylePara elsevierViewall">The first case is a 66-year-old woman with an initial diagnosis of diabetic macular edema in the right eye (RE), with no other signs of associated diabetic retinopathy. Visual acuity (VA) was 0.7 in the RE and 1 in the left eye (LE). The fundus examination (OF) of the RE showed a juxtafoveal hemorrhage with macular thickening, while the LE showed no alterations. OCT of the RE showed macular edema with central cysts and a hyper-reflective wall cyst, while angio-OCT showed deep plexus involvement with a hyper-reflective spot (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Treatment with intravitreal extended-release dexamethasone was performed with no improvement after one year of follow-up.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The second case is an 80-year-old male diagnosed with exudative AMD in the left eye, with no other associated cardiovascular diseases. The VA was 0.5 in the RE and 0.32 in the LE. Punctate hemorrhages were observed in the OF of the LE. OCT of the LE revealed cysts at macular level; angio-OCT and En-face, a hyper-reflective spot in the deep plexus, and FAG of the LE, a small perifoveal temporal microaneurysm with diffusion at mid and late times of the angiogram, ruling out associated neovascularisation (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). After a year of follow-up and treatment with intravitreal anti-angiogenic drugs, there was no improvement in the condition (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The third case is a 23-year-old male with type 1 diabetes mellitus referred to Endocrinology for follow-up. In the OF of the RE, juxtafoveolar lipid microexudates were observed, with a VA of 0.8 in the RE and 1 in the LE. There were no other signs of diabetic retinopathy in both eyes. Macular OCT of the RE showed hard exudates and a microaneurysmal lesion; angio-OCT and En-face, a hyperreflective spot in deep plexus, and FAG showed microaneurysms in posterior pole with minimal paramacular exudative component at late times, with no signs of peripheral ischemia (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). After one year of follow-up, no OCT changes were observed.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">PEVACs represent a usually isolated aneurysmal lesion, although multiple and bilateral cases have been described in patients without associated vascular disease, and are still poorly understood.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The differential diagnosis should include macular telangiectasias type 1, macular neovascularisation type 3 (retinal angiomatous proliferation <span class="elsevierStyleItalic">(</span>RAP) and aneurysmal changes in diabetic retinopathy or vaso-occlusive diseases. While PEVACs are considered isolated vascular changes in otherwise healthy eyes, the other lesions would be microangiopathy associated with underlying retinal vascular pathologies.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Although initially described as isolated findings, they have recently been published in association with retinal pathologies such as AMD, myopia and pachychoroidopathy, among others. Thus, one of our cases had associated exudative AMD, while the other two were diabetic patients without associated retinopathy.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Its pathogenesis is not yet known, and a possible loss of pericytes associated with systemic cardiovascular alterations or the deterioration of retinal vascularisation associated with ageing has been postulated.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> In this regard, two of our patients were elderly (66 and 80 years). However, the third patient was 23. This suggested a finding related to his diabetes. However, the fact that he did not have associated retinopathy led to the diagnosis, by exclusion, of PEVAC.</p><p id="par0060" class="elsevierStylePara elsevierViewall">With regard to treatment, there is no agreement on the most appropriate procedure. Except in isolated cases, there seems to be no response to anti-angiogenic treatment, with selective focal laser treatment being the most promising.</p><p id="par0065" class="elsevierStylePara elsevierViewall">In conclusion, VAPECs are a poorly understood entity and need to be included in the differential diagnosis of macular aneurysmal retinal aneurysms to avoid unnecessary treatments such as anti-angiogenic therapy.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflict of interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">No conflicts of interest were declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1924337" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1659208" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1924338" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1659207" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinical cases" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-02-08" "fechaAceptado" => "2023-04-27" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1659208" "palabras" => array:2 [ 0 => "Perifoveal exudative vascular anomalous complex" 1 => "Aneurysmal dilatation" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1659207" "palabras" => array:2 [ 0 => "Complejo anómalo vascular exudativo perifoveal" 1 => "Dilatación aneurismática" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We present three cases of patients aged 66, 80 and 23, who presented unilateral vision loss. Optical coherence tomography (OCT) in all of them showed macular oedema and a rounded lesion with hyperreflective wall, and fluorescein angiography (FAG) in two of them showed hyperfluorescent perifoveal aneurysmal dilations with exudation.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">None of the cases showed response to treatment after one year of follow-up, finally being diagnosed with Perifoveal Exudative Vascular Anomalous Complex (PEVAC).</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se presentan 3 casos de pacientes, con 66, 80 y 23 años de edad, que presentaron una pérdida de visión unilateral. La tomografía de coherencia óptica (OCT) mostró edema macular junto con una lesión redondeada de pared hiperreflectiva y la angiografía con fluoresceína (AFG) de dos de ellos, dilataciones aneurismáticas perifoveales hiperfluorescentes con exudación.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Ninguno de los casos mostró respuesta al tratamiento tras un año de seguimiento, diagnosticándose finalmente de Complejo Anómalo Vascular Exudativo Perifoveal (PEVAC).</p></span>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1891 "Ancho" => 2340 "Tamanyo" => 301581 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">OCT and angio-OCT of right eye of case 1. (A) OCT RE shows macular edema with central cysts. The red arrow points to a cyst with a hyper-reflective wall. (B) AngioOCT: deep plexus involvement, with hyperreflective spot, indicated by orange arrows. (C) Colour fundus photograph of the right eye.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1654 "Ancho" => 2340 "Tamanyo" => 251713 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">OCT, angio-OCT, En-face and fluorescein angiography of the left eye of case 2. (A) Macular OCT: shows cysts at macular level. (B) Angio-OCT and En-face: hyperreflective spot in deep plexus. (C) FAG: small perifoveal temporal perifoveal microaneurysm with diffusion in mid and late angiogram times, marked with red arrow, ruling out associated neovascularisation. (D) Colour fundus photograph of the left eye.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1836 "Ancho" => 2540 "Tamanyo" => 309016 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">OCT, angio-OCT, En-face and fluorescein angiography of the left eye of case 3. (A) Macular OCT of the left eye: shows hard exudates and microaneurysmal lesion marked with red arrow. (B) Angio-OCT and en face: hyperreflective spot in deep plexus. (C) FAG: microaneurysm in posterior pole, marked with red arrow, with minimal paramacular exudative component at late times, with no signs of peripheral ischemia. (D) Colour fundus photograph of the left eye.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perifoveal exudative vascular anomalous complex" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Querques" 1 => "D. Kuhn" 2 => "N. Massamba" 3 => "N. Leveziel" 4 => "L. Querques" 5 => "E.H. Souied" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jfo.2011.03.002" "Revista" => array:3 [ "tituloSerie" => "J Fr Ophtalmol" "fecha" => "2011" "volumen" => "34" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The expanded spectrum of perifoveal exudative vascular anomalous complex" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Sacconi" 1 => "K.B. Freund" 2 => "L.A. Yannuzzi" 3 => "R. Dolz-Marco" 4 => "E. Souied" 5 => "V. Capuano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ajo.2017.10.009" "Revista" => array:6 [ "tituloSerie" => "Am J Ophthalmol" "fecha" => "2017" "volumen" => "184" "paginaInicial" => "137" "paginaFinal" => "146" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29079450" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Atypical perifoveal exudative vascular anomalous complex (PEVAC) with multifocal and bilateral presentation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.I. Fernández-Vigo" 1 => "B. Burgos-Blasco" 2 => "R. Dolz-Marco" 3 => "M. Jiménez-Santos" 4 => "L. López-Guajardo" 5 => "J. Donate-López" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ajoc.2020.100717" "Revista" => array:3 [ "tituloSerie" => "Am J Ophthalmol Case Rep." "fecha" => "2020" "volumen" => "18" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anatomical changes on sequential multimodal imaging in perifoveal exudative vascular anomalous complex" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.S.N. Verhoekx" 1 => "L.M. Smid" 2 => "K.A. Vermeer" 3 => "J.P. Martinez Ciriano" 4 => "S. Yzer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/IAE.0000000000002809" "Revista" => array:6 [ "tituloSerie" => "Retina" "fecha" => "2021" "volumen" => "41" "paginaInicial" => "162" "paginaFinal" => "169" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32271275" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perifoveal exudative vascular anomalous complex in a highly myopic eye" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Sacconi" 1 => "E. Borrelli" 2 => "F. Bandello" 3 => "G. Querques" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/2515841420947930" "Revista" => array:3 [ "tituloSerie" => "Ther Adv Ophthalmol" "fecha" => "2020" "volumen" => "12" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Atypical case of perifoveal exudative vascular anomalous complex associated with pachychoroid pigment epitheliopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Herda" 1 => "O. Semoun" 2 => "M. Srour" 3 => "F. Amoroso" 4 => "M. Baker" 5 => "V. Capuano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ajoc.2022.101691" "Revista" => array:3 [ "tituloSerie" => "Am J Ophthalmol Case Rep" "fecha" => "2022" "volumen" => "28" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Case report: perifoveal exudative vascular anomalous complex in a Chinese patient with diabetes mellitus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Z. Zhang" 1 => "L. Xu" 2 => "Z. Wu" 3 => "J. Zhang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/OPX.0000000000001401" "Revista" => array:6 [ "tituloSerie" => "Optom Vis Sci" "fecha" => "2019" "volumen" => "96" "paginaInicial" => "531" "paginaFinal" => "535" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31274742" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multimodal imaging in perifoveal exudative vascular anomalous complex with co-existent diabetic retinopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Venkatesh" 1 => "N.K. Yadav" 2 => "B. Bavaharan" 3 => "V. Prabhu" 4 => "S. Sinha" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/cxo.12868" "Revista" => array:6 [ "tituloSerie" => "Clin Exp Optom" "fecha" => "2019" "volumen" => "102" "paginaInicial" => "528" "paginaFinal" => "532" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30620998" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nonexudative perifoveal vascular anomalous complex: the subclinical stage of perifoveal exudative vascular anomalous complex?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Sacconi" 1 => "E. Borrelli" 2 => "S.V. Sadda" 3 => "G. Corradetti" 4 => "K.B. Freund" 5 => "L.A. Yannuzzi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ajo.2020.04.025" "Revista" => array:6 [ "tituloSerie" => "Am J Ophthalmol" "fecha" => "2020" "volumen" => "218" "paginaInicial" => "59" "paginaFinal" => "67" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32360340" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multimodal imaging comparison of perifoveal exudative vascular anomalous complex and resembling lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L.M. Smid" 1 => "J.S.N. Verhoekx" 2 => "J.P. Martinez Ciriano" 3 => "K.A. Vermeer" 4 => "S. Yzer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/aos.14650" "Revista" => array:6 [ "tituloSerie" => "Acta Ophthalmol" "fecha" => "2021" "volumen" => "99" "paginaInicial" => "553" "paginaFinal" => "558" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33210824" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009800000007/v1_202307031243/S2173579423000877/v1_202307031243/en/main.assets" "Apartado" => array:4 [ "identificador" => "8724" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Short communication" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009800000007/v1_202307031243/S2173579423000877/v1_202307031243/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579423000877?idApp=UINPBA00004N" ]
