Chronic BRVO

Chronic BRVO of the superotemporal quadrant demonstrating marked venous sheathing, areas of intraretinal hemorrhages, hard exudates, and collateral vessels crossing the horizontal raphe and draining into the venous circulation of the inferotemporal quadrant. 

  • Clearing of the retinal hemorrhages after BRVO usually occurs in 3-6 months.

Clinical features:

  • Symptoms:
    • Maybe asymptomatic
    • Visual loss if associated with macular edema
    • Unilateral visual field defect
  • Signs:
    • Marked sheathing or narrowing of the occluded vein
    • Chronic leakage from these abnormal vessels that contribute to accumulation of hard exudates
    • Collateral vessels with following characteristics:
      • Small and tortuous
      • Commonly cross from the territory of the occlusion to an uninvolved vein
      • May cross the horizontal raphe and drain into the venous circulation of the uninvolved quadrant
  • Can be complicated with retinal or optic disc neovascularization, preretinal membrane formation, and rhegmatogenous retinal detachment.