Extrafoveal vitreous traction associated with branch retinal vein occlusion

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

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.

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.

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.