Extrafoveal vitreous traction associated with branch retinal vein occlusion

Abstract

Purpose: To present patients with extrafoveal vitreous traction associated with diffuse macular edema secondary to branch retinal vein occlusion (BRVO).

Methods: A retrospective study on consecutive patients with BRVO using optical coherence tomography (OCT)-2000 is reported. Excluded were patients with eyes with other retinopathies that could affect analysis and eyes following pars plana vitrectomy (PPV). A control group of 30 age-matched patients allowed for normal OCT 6-mm macular maps.

Results: Vitreous traction was detected in 4 of 17 eyes (17 patients, 23.5%). The traction was located extrafoveally in each of the 4 eyes. In one eye there was a simultaneous central macular traction. Only the manually controlled OCT-Line group program, but not the central automatic 6-radial lines program, confirmed vitreous traction in each case. Retinal edema (n = 4) and serous retinal detachment (n = 2) underlining the traction sites were in continuum with the central macula in 3 eyes, presenting either as diffuse macular edema or combined with serous macular detachment, respectively. In one eye the edema subsided after PPV, and visual acuity stabilized during 7 postoperative months of follow-up. Macular thickness and visual acuity of another eye improved temporarily in repeated conventional treatments after PPV was discarded, but its fovea markedly atrophied 12 months later.

Conclusions: Extrafoveal vitreous traction may be apparent following BRVO. Further studies are required to assess whether such traction membranes may play a role in the persistence of diffuse macular edema.