Atlas of Ophthalmology

Branch Retinal Vein Occlusion with Corresponding Relative Scotoma (VF)

Branch Retinal Vein Occlusion with Corresponding Relative Scotoma (VF)
Visual Field: relative scotoma corresponding to chronic branch retinal vein occlusion in upper hemisphere. Patient: Male, 72 years of age, BCVA 0.5 at OD, 0.5 at OS; IOP 15/15 mmHg General Medical History: arterial hypertension. Ocular Medical History: hypertensive retinopathy at fellow eye. Main Complaint: blurred vision. Purpose: to demonstrate OCT-A features in branch retinal vein occlusion including regular capillary perfusion in superficial macular layer and impaired capillary perfusion in deep macular layer Methods: Colour Photography Posterior Pole, FFA, Triton-OCT, Triton-OCTA, Visual Field. Findings: Colour Photography Posterior Pole: chronic branch retinal vein occlusion in upper hemisphere, hard exsudates, retinal hemorrhages. FFA: chronic branch vein occlusion with venous-venous shunting, micro- and macroaneurysms, ischemic areas, diffuse loss of capillary perfusion in the superior retina, focal areas of staining consistent with intraretinal fluid. Triton OCT-A, paramacular area, superficial layer: regular capillary blood flow. Triton OCT-A, paramacular area, deep layer: venous-venous shunting, and microaneurysms. Triton OCT, macula, horizontal line: chronic branch vein occlusion with retinal and cystoid macular edema, hard exsudates. Triton OCT, macula, vertical line: chronic branch vein occlusion with retinal and cystoid macular edema. Visual Field: relative scotoma corresponding to chronic branch retinal vein occlusion in upper hemisphere. Mosaic (Colour Photography Posterior Pole, OCTA, OCT): chronic branch retinal vein occlusion, cystoid macular edema, hard exsudates, retinal hemorrhages, superficial vascular layer presenting regular capillary blood flow, and deep vascular layer showing microaneurysm and shunting vessels . Discussion: Optical coherence tomography angiography (OCTA) enables mapping of retinal vascular layers and visualizing nonperfused areas. OCT-A is effective for evaluation of macular complications of RVO. Suzuki et al. (1) evaluating the retinal hemodynamics noninvasively by OCTA found that anti-VEGF therapy improved the retinal deep ischemia in RVOs. Literature: 1. Suzuki N, Hirano Y, Tomiyasu T, Esaki Y, Uemura A, Yasukawa T, Yoshida M, Ogura Y. Retinal Hemodynamics Seen on Optical Coherence Tomography Angiography Before and After Treatment of Retinal Vein Occlusion. Invest Ophthalmol Vis Sci.2016 Oct 1;57(13):5681-5687
Michelson, Georg, Prof. Dr. med., Interdisciplinary Center of Preventive Ophthalmic Medicine and Imaging, Friedrich-Alexander University, Erlangen, Erlangen, Germany
H34.832
Retina -> Vascular Diseases (see also: Systemic Immunologic Diseases) -> Retinal Vein Occlusion -> Branch Retinal Vein Occlusion with Impaired Circulation in Deep Retinal Layer (Colour Photography Posterior Pole, OCT-A, OCT, Visual Field, FFA)
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