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To report frequency, clinical characteristics, treatment, and the complications of branch retinal vein occlusion (BRVO) with serous macular detachment.We retrospectively studied 22 eyes of 22 patients in 111 eyes with acute BRVO, whose eyes had serous macular detachment that was detected by optical coherence tomography (OCT). Fluorescein angiography was conducted in 19 of the 22 eyes. Fourteen of the 22 eyes underwent scatter laser photocoagulation of the BRVO area. We observed serial OCT findings before and after treatment.Approximately 20% of the BRVO eyes had serous macular detachment. The superotemporal vein was occluded in 15 eyes and the inferotemporal vein was involved in 7 eyes. Four eyes were ischemic and 15 eyes were not ischemic. Extensive dye leakage was observed in the BRVO area in all examined eyes (19 eyes). The occlusion area of perifoveal capillary network ranged from 5 to 60%, with an average of 40%. OCT demonstrated pure serous macular detachment in 13 eyes and the remaining 9 eyes had both serous macular detachment and cystoid macular edema(CME). The occlusion area of perifoveal capillaries in these 9 eyes was more than 20%. Serous macular detachment was resolved in 11 of 14 eyes (80%) 6 months after laser treatment. The average period for resolution of macular detachment was 3.4 months after treatment. Visual acuity was improved more than 2 lines in 8 of the treated 11 eyes (73%). Hard exudates appeared in the posterior fundus in 13 of 14 treated eyes (93%) and in 16 of the total of 22 eyes (73%) in the follow-up period. Massive macular hard exudates and ensuing macular atrophy resulted in poor visual outcome.Serous macular detachment is one of the patterns of macular edema in BRVO. OCT is an essential tool to detect it. Leakage from the entire BRVO area seems to travel via subretinal space by gravity or other factors and may form serous detachment in the macular area. Laser photocoagulation is indicated for early resolution of serous macular detachment. The major complication of serous detachment is the deposit of macular hard exudates, which may result in poor visual outcome.

Background: It has been shown, by indocyanine green (ICG) videoangiography, that the prepapillary vascular loops in chronic central retinal vein occlusion (CRVO) serve as an anastomosis between the retina and the choroidal venous systems. Similar vascular loops may develop in hemi-central retinal vein occlusion (hemi-CRVO). Cases and Methods: I performed indocyanine green and fluorescein angiography using a scanning laser ophthalmoscope in 8 eyes of 8 patients with hemi-CRVO to evaluate the angioarchitecture and hemodynamics of the retinochoroidal circulation. All eyes had a prepapillary vascular loop and were identified as ischemic. The patients' ages ranged from 28 to 77 years (mean, 57 years). The interval between onset of hemi-CRVO and angiography ranged from 2 to 42 months (mean, 13 months). Scattered laser photocoagulation had been applied to the affected area in all 8 eyes and vitreous surgery in one eye. Results: Delayed dye flow in the affected retinal veins was present in all 8 eyes. The blood in the affected retinal veins drained through the prepapillary vascular loop into the branch or trunk of the intact central retinal vein. No anastomoses were seen between the vascular loop and the choroidal veins. The prepapillary vascular loop became more dilated during follow-up in one eye. Conclusions: The prepapillary vascular loop in hemi-CRVO served as a collateral from the affected into intact retinal veins and not into the choroidal venous system. (J Jpn Ophthalmol Soc 103:404–408, 1999)