Three Sequential Branch Retinal Vein Occlusions in Two Eyes

Fundus images of a 66 year-old, hypertensive man with a history of coronary artery disease who was seen in 2008 with a history of one month of blurred vision of the right eye. At presentation he had three independent branch retinal vein occlusions (BRVO) in two eyes. A - Monochromatic fundus photograph of the right eye shows a fresh superotemporal branch retinal vein occlusion (the turquoise arrow) and an unsuspected, old inferotemporal BRVO (the yellow arrow). B - Monochromatic fundus photograph of the left eye shows an unsuspected, old superonasal macular BRVO (the yellow oval) C - Frame from the late phase fluorescein angiogram of the right eye shows no hyperpermeability of the retinal venules and capillaries associated with the right eye inferotemporal BRVO (the yellow oval) but prominent hyperpermeability of the capillaries associated with the superotemporal BRVO (the turquoise oval). D - Frame from the late phase fluorescein angiogram of the left eye showing a focus of hyperpermeable capillaries associated with the superonasal macular branch retinal vein occlusion. The green arrow indicates the site of a second BRVO that developed in this eye in 2011, three years after the date of this photograph.