Branch Retinal Vein Occlusion with Ischemia and Macular Atrophy

Fundus images of a 56 year old hypertensive woman with an old ischemic inferotemporal branch retinal vein occlusion. The best corrected visual acuity was 20/63. A - Color fundus photograph shows the sheathed first order branch retinal vein (arrow). The arterioles have increased light reflexes consistent with chronic hypertension. Small venular remodeling can be seen in the inferior macula. B - Frame from the early phase fluorescein angiogram of the right eye. The arrow denotes the disruption of the perifoveal capillary arcade. Other areas of capillary nonperfusion are evident in the inferotemporal quadrant. Despite the ischemia, no neovascularization is present. C - Frame from the late phase of the fluorescein angiogram of the right eye. Although there is some staining of venular walls, there is little leakage of fluorescein into the interstitium. D - SD-OCT line image through the right macula shows atrophy of the inner retina temporally (arrow). The demarcation between cell layers is effaced and the nerve fiber and ganglion cell layers are thin compared to the normal fellow eye (see E). E - SD-OCT line image through the left macula. The arrow denotes the normal temporal macular thickness and profile (compare to D).