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77-year-old woman had a macular branch retinal vein occlusion in the left eye, which wasn’t affecting the fovea. She is noticing some discomfort around her eyes and around her forehead. It is not really pain or headaches, but it is discomfort and she was concerned about the eye and also she is having impending radiation to a lesion in her brain and she was concerned how that might affect her eyes. Her vision is reasonable. VISUAL ACUITY: OD 20/25, OS 20/30. IOP: OD 20, OS 15. There is 1+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.3. There is a dot hemorrhage nasal to the fovea. OS: Vertical C/D ratio is 0.3. There is a superotemporal and inferotemporal macular branch retinal vein occlusion with hemorrhage. OCT SCAN: The OCT scan shows an average central foveal thickness in the right eye of 221 microns and the left eye has 193 microns, both of which are normal. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows blockage of the superotemporal and inferotemporal branch retinal vein occlusion in the left eye, but they are far enough away from the optic nerve that there is still some circulation getting through to the fovea. The inferior temporal vein is blocked more than the superotemporal vein. The right eye where the hemorrhage is nasal to the fovea looks okay angiographically. IMPRESSION: 1. SUPEROTEMPORAL AND INFEROTEMPORAL MACULAR BRANCH RETINAL VEIN OCCLUSION – LEFT EYE WITHOUT MACULAR EDEMA 2. RETINAL HEMORRHAGE – RIGHT EYE 3. CATARACTS DISCUSSION: I explained to the patient she does now have two blocked retinal veins in the left eye and because of that I asked her to return for a check in three to six months. At this moment they are not affecting her central vision. Note: Patient did develop macular edema responsive to avastin.

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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 486 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 253 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 237 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 235 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 221 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 179 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 309 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 186 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 164 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 167 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 163 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 123 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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Macular Branch Retinal Vein Occlusions (2) Left Eye - No Macular Edema (yet) 141 views77-year-old woman with two macular branch retinal vein occlusions in the left eye OD 20/2500000
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77-year-old woman had a macular branch retinal vein occlusion in the left eye, which wasn’t affecting the fovea. She is noticing some discomfort around her eyes and around her forehead. It is not really pain or headaches, but it is discomfort and she was concerned about the eye and also she is having impending radiation to a lesion in her brain and she was concerned how that might affect her eyes. Her vision is reasonable. VISUAL ACUITY: OD 20/25, OS 20/30. IOP: OD 20, OS 15. There is 1+ nuclear sclerosis in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.3. There is a dot hemorrhage nasal to the fovea. OS: Vertical C/D ratio is 0.3. There is a superotemporal and inferotemporal macular branch retinal vein occlusion with hemorrhage. OCT SCAN: The OCT scan shows an average central foveal thickness in the right eye of 221 microns and the left eye has 193 microns, both of which are normal. Photos confirm clinical findings. FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows blockage of the superotemporal and inferotemporal branch retinal vein occlusion in the left eye, but they are far enough away from the optic nerve that there is still some circulation getting through to the fovea. The inferior temporal vein is blocked more than the superotemporal vein. The right eye where the hemorrhage is nasal to the fovea looks okay angiographically. IMPRESSION: 1. SUPEROTEMPORAL AND INFEROTEMPORAL MACULAR BRANCH RETINAL VEIN OCCLUSION – LEFT EYE WITHOUT MACULAR EDEMA 2. RETINAL HEMORRHAGE – RIGHT EYE 3. CATARACTS DISCUSSION: I explained to the patient she does now have two blocked retinal veins in the left eye and because of that I asked her to return for a check in three to six months. At this moment they are not affecting her central vision. Note: Patient did develop macular edema responsive to avastin.