Macular Oedema and Retinal Branch Vein Occlusion

Abstract

The visual prognosis of patients suffering from retinal branch vein occlusion complicated by macular oedema is assessed in relation to the degress of capillary fallout. Extensive retinal capillary fallout associated with macular oedema was found to confer a poor visual prognosis in a series of 89 patients foNowed for an average time of 14 months. If the degree of capillary fallout associated with marular oedema was minimal, the visual prognosis was considerably improved. The most common cause of reduced central vision in retinal branch vein occlusions is macular oedema. Macular oedema complicates approximately 60% of temporal branch vein occlusions and becomes chronic in two-thuds of these cases.' ' Retinal 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. Method Eighty-nine consecutive patients suffering from retinal branch vein occlusion were examined by one of the authors and underwent retinal photography with fluorescein angiography. Results Forty-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,

Intravitreal triamcinolone acetonide versus bevacizumab therapy for macular edema associated with branch retinal vein occlusion

“…The most important factor in central visual loss resulting from BRVO is macular edema, which has been reported in 60% of patients [4,5].…”

“…The biological activities of triamcinolone acetonide and bevacizumab in the vitreous differ [5,[10][11][12][13] and drug efficacies might thus also be distinct.…”

Intravitreal bevacizumab vs. sham treatment in acute branch retinal vein occlusion with macular edema: results at 3 months (Report 1)

“…Macular edema is the most common cause of vision loss and can be seen in 60% of patients [4]. The only standard treatment for BRVO to date is based on the results of the branch Vein Occlusion Study (BVOS), which suggested that macular photocoagulation of eyes with macular edema should be delayed for at least 3 months to permit maximal spontaneous resolution of the edema and intraretinal blood [1].…”

Prognostic factors for visual outcome after intravitreal bevacizumab for macular edema due to branch retinal vein occlusion

“…The most common cause of visual disturbance in BRVO patients is macular edema, which has been reported in 60% of patients [3]. Macular grid laser photocoagulation has been shown to be effective in the treatment of macular edema arising from BRVO [2].…”