Atlas of Ophthalmology

Ischemic Retinal Branch Vein Occlusion (Colour Image, Fluorescein Angiography)

Retina -> Vascular Diseases (see also: Systemic Immunologic Diseases) -> Retinal Vein Occlusion
Female subject, 42 years of age BCVA 0.16 OS, IOP 16 mmHg OS Main symptoms: Since 7 months decreased vision at OS Ocular medical history: Empty Medical history: arterial hypertension Colour image showing retinal hemorraghes and retinal microinfarcts. Fluorescein angiography was performed. The area of capillary nonperfusion was measured on an early-phase fluorescein angiography image. The area was expressed relative to the optic disk area (DA). We found an area of capillary nonperfusion about 18 DA. It was suggested, that hemodynamic changes downstream of the A/V crossing may be essential in the pathogenesis of BRVO. Muraoka et al. (1) performed sequential thin sectioning with OCT. This allowed detailed anatomic correlation between the artery and the vein, revealing that BRVO occurred at the arterial overcrossing in about 70% of the eyes investigated. At the venous overcrossing, the mechanical compression caused by the Inner Limiting Membrane ILM and the arterial walls at the crossing would be primarily related to the onset of BRVO. The affected veins were compressed and choked between the ILM and the arterial wall at the venous overcrossing. Literature (1) Muraoka Y, Tsujikawa A, Murakami T, Ogino K, Kumagai K, Miyamoto K, Uji A, Yoshimura N. Morphologic and Functional Changes in Retinal Vessels Associated with Branch Retinal Vein Occlusion. Ophthalmology. 2012 Sep 12. pii: S0161-6420(12)00614-8. doi: 10.1016/j.ophtha.2012.06.054.

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