Branch Retinal Vein Occlusion with Macular Edema

Fundus images of a 74 year-old man with primary open angle glaucoma and a branch retinal vein occlusion. A - Monochromatic fundus photograph showing a sector of intraretinal hemorrhages in the superotemporal quadrant. B - magnified monochromatic photograph of the optic disc. Glaucomatous cupping is present, as is a peripapillary zone of retinal pigment epithelial atrophy. The site of the vein occlusion is not at the arteriovenous crossing (green arrow). Instead, the site of the occlusion is at the rim of the optic cup (red arrow) as manifested by the venous dilation proximal to the arteriovenous crossing but co-localized with the rim of the optic disc cup. C - By a fluorescein angiographic classification system, this branch vein occlusion is nonischemic. This frame from the mid-phase fluorescein angiogram shows that the perifoveal capillary border is intact and that capillary perfusion is present throughout the area of distribution of the retinal hemorrhages. D - Frame from the late phase fluorescein angiogram shows that the retinal vessels in the superotemporal macula leak fluorescein. E - Optical coherence tomography from 10/29/2010 shows cystoid macular edema. The best corrected visual acuity was 20/50. The patient elected no treatment. The patient returned on 2/1/2011 with visual acuity reduced to 20/70 and with worsening of the macular edema on OCT.