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ABSTRACT
In this study of branch retinal vein occlusion, we distinguished between cystoid macular edema caused by increased capillary pressure and noncystoid edema due to hard exudates in the macula caused by chronic leakage from vascular abnormalities in the posterior pole or midperiphery. We performed laser photocoagulation in 51 eyes with cystoid macular edema to achieve focal narrowing of the retinal arterioles perfusing the macular area affected by the cystoid edema; good anatomic and functional results were achieved in 40 of these eyes (78%). In 25 of the five eyes, the treated segment of the retinal arteriole was outside the area of macular edema; results were successful in 19 of these eyes (76%). In 14 eyes with noncystoid exudative macular edema, we performed laser photocoagulation to the vascular abnormalities; good anatomic and functional results were obtained in 12 of these (86%).
Branch retinal vein occlusion (BRVO) is the second most common retinal vascular disease after diabetic retinopathy.1 It mostly affects patients 50 years and older, and visual loss is usually due to macular edema or hemorrhages, or to vitreous hemorrhage from bleeding new vessels.2 The management of BRVO consists of treating the underlying systemic disease, most commonly hypertension,3 and photocoagulation directed toward the macular edema and neovascularization. Macular edema is the most frequent cause of decreased vision in BRVO.4 Successful results have been reported with argon laser photocoagulation.5,6
In a randomized, controlled clinical trial, the Branch Vein Occlusion Study (BVOS) demonstrated the value of photocoagulation in BRVO eyes with macular edema, and recommended placing a grid pattern of laser applications in the area of macular edema, sparing the foveal avascular zone.1 To our knowledge, none of the reported studies distinguished between the different types of macular edema that can occur in BRVO. In our study of 64 eyes with BRVO and macular edema, we distinguished two types of macular edema and used a photocoagulation technique specific to each type and different from the one described by the BVOS.
MATERIALS AND METHODS
We reviewed the records of 63 consecutive patients, 29 men and 34 women (65 eyes) with BRVO and macular edema who had been seen and treated between 1980 and 1985. The age range was 52 to 74 years (mean, 66 years). Excluded...