Collateral branches in macular venous branch occlusion

Figure 1. Color retinography of the right eye, showing collateral circulation passing through the median raphe at the level of the papillomacular bundle.

Figure 2. OCT of the right eye. Integrity of the outer retina, without macular edema.

Dra Bárbara Delás

Description

Retinal vein occlusion (RVO) is the second cause of vision loss due to retinal vascular pathology, after diabetic retinopathy. Branch vein obstruction (BRVO) is more common than central retinal vein obstruction (CRVO). Macular branch occlusion (MBO) is limited to a small branch that drains a specific sector of the macular area, with cystoid macular edema being the main cause of vision loss in these cases. The visual prognosis will depend on the location where the occlusion has occurred, the extent of ischemia, and the efficiency of collateral circulation development.

Comments

Indication

A 60-year-old woman of Moroccan origin, with a history of poorly controlled arterial hypertension, was followed by ophthalmology check-ups for a 10-year history of macular branch venous occlusion in her left eye. During the first 4 years of follow-up, she required anti-angiogenic intravitreal treatment, with good functional and anatomical resolution, but with recurrence of macular edema. During the fifth year, however, complete resolution of the edema and the development of collateral circulation were observed (Figure 1), maintaining a visual acuity of one unit, without macular edema (Figure 2).