Macular Oedema and Retinal Branch Vein Occlusion

Abstract

SummaryRetinal branch vein occlusion is a common cause of retinal vascular disease and because macular oedema is a frequent complication, prognostic factors in these cases have been closely studied?From these investigations, suggested factors with prognostic signficance have been the site of occlusion, extent of the macular oedema and disruption of the foveal arcade.The retinal vasculature has been described as responding in two ways to venous occlusion.' The blood vessels may become dilated and leak as a result of disruption of the blood retinal barrier. Alternatively, an ischaemic change may occur and this is maiifested by capillary closure. It has been appreciated that these responses may co-exist but most investigators have discussed them separately, emphasising abnormal permeabdity alone as the cause of macular oedema. MethodEighty-nine consecutive patients suffering from retinal branch vein occlusion were examined by one of the authors and underwent retinal photography with fluorescein angiography. ResultsForty-eight patients (53%) had detectable macular oedema on fluorescein angiography. The duration of symptoms before examination varied from six weeks to 28 months but most patients were seen two to three months after the onset of symptoms. The patients were followed for an average of 14 months with minimum follow-up time of five months. There was no significant sex difference (female 47'70, male 5370) and the average age of presentation was 63 years. The right eye was affected in 5570, the left in 41% and in 4% the retinal branch vein occlusions were bilateral. The site of occlusion is shown in Table 1 and the branch vein occlusions complicated by macular oedema had a similar distribution to the overall series. Of the 48 patients with macular oedema,

Combined intravitreal triamcinolone injection and laser photocoagulation in eyes with persistent macular edema after branch retinal vein occlusion

“…Visual loss in BRVO is either caused by local ischemia, intraretinal hemorrhages, or macular edema. The latter is the most common cause of long-standing poor visual outcome secondary to BRVO [3]. So far, laser photocoagulation is the gold standard of treatment in cases with BRVO, following the recommendations of the Branch Vein Occlusion Study (BVO) [1], the only randomized long-term evaluation of any therapy in this retinal vascular disease.…”

Intravitreal triamcinolone acetonide vs bevacizumab for treatment of macular oedema secondary to branch retinal vein occlusion

“…[7][8][9] Macular oedema is the major cause of visual disturbance in BRVO, occurring in about 60% of cases. 10 The degree of macular involvement determines the level of visual impairment. At present, macular grid laser photocoagulation has been the only established treatment modality for macular oedema arising from BRVO, but the visual acuity improvement is often very limited (average improvement in vision of 1.33 Snellen lines).…”

Comparison of Bevacizumab and Triamcinolone for Treatment of Macular Edema Secondary to Branch Retinal Vein Occlusion in a Pair-Matched Analysis

“…ME is a main cause of severe visual impairment after BRVO, which is a common vascular retinal disease [1,2]. The BRVO study demonstrated that laser-treated eyes on average gained 1.33 lines at 3 years after grid laser treatment [4].…”

“…In the age group over 49 years, the cumulative incidence of BRVO is about 1.2% in 10 years [1]. Macular edema (ME) is the most frequent complication of BRVO (60%) and a major cause of visual loss in BRVO patients [2]. Vision can also be diminished by ischemia and vitreous hemorrhage from neovascularization.…”