Branch Retinal Vein Occlusion with Epiretinal Membrane

A 77 year old man with hypertension had a history of bilateral branch retinal vein occlusions (BRVOs). The left BRVO occurred in 1997, was associated with macular edema treated by grid laser, but never regained better than 20/200 visual acuity. In 2007, examination showed a macular epiretinal membrane and chronic cystoid macular edema. A - Frame from the mid phase fluorescein angiogram shows the irregular telangiectasia superotemporal to the fovea. B - Frame from the late phase of the fluorescein angiogram shows petalloid hyperfluorescence surrounding a hypofluorescent area (yellow oval) that was a large cyst (see C). C- A linear SD-OCT scan shows the large central cyst (green arrow) and a macular epiretinal membrane (yellow arrow). D - Four linear SD-OCT scans that straddle the central scan of C from the 5 raster display show different cuts through the large macular cyst and the overlying epiretinal membrane (yellow arrow). Surgery was not offered to the patient in view of the 10 year history of the problem and poor vision and the low probability of improving visual function even with technically successful surgery.