Natural history of macular status in recent-onset branch retinal vein occlusion: an optical coherence tomography study.

PURPOSE: To evaluate serially the course of structural changes in the macula in recent onset branch retinal vein occlusion (BRVO), using optical coherence tomography (OCT).

METHODS

Twenty eyes of patients at an institutional practice with recent onset BRVO were examined by OCT at presentation and at 3 and 6 months of onset of the occlusion. The macular thickness (MT) and the visual acuity were correlated with the macular perfusion status and analyzed statistically.

RESULTS

The mean MT at presentation, 3 and 6 months was 398.9 +/- 98.6 mm, 346.8 +/- 84.8 mm and 341.3 +/- 95.3 mm, respectively. Three distinct anatomical patterns of structural changes were appreciated on OCT-serous retinal detachment (SRD) only in 15%, cystoid macular edema (CME) only in 40%, and a combined form with both SRD and CME in 45%. At 6 months while the non-ischemic group showed an average percentage decline of 26.8% in thickness, the ischemic group showed an increase of 19.2% (P < 0.01). CME resolved in 10 of 13 perfused (non-ischemic) maculae, but persisted in all seven ischemic cases.

CONCLUSION

OCT delineates macular changes at a stage when fundus biomicroscopy and fluorescein angiography are not very informative. The anatomical cause for the increase in MT i.e., SRD and/or CME is also well delineated. Non-ischemic maculae show an early and more rapid decline in MT compared with ischemic occlusions. An increase in MT at 3 months on OCT in BRVO patients could be an indication of a possible ischemic course.