Foveal neovascularization in combined branch retinal vein and artery occlusion

Abstract

Purpose: To describe a case of combined branch retinal vein and artery occlusion (CBRVAO) complicated by foveal neovascularization (FNV).

Observations: A 52-year-old healthy woman presented at the Eye Clinic of Sacco Hospital (Milan, Italy) with a 3-year history of CBRVAO in her right eye. At baseline, her visual acuity was 20/20 Snellen with unremarkable anterior segment and normal intra-ocular pressure. On fundoscopy, a reddish foveal lesion with an underlying crescent-shaped pre-retinal subhyaloid hemorrhage could be appreciated. FNV was confirmed by means of fluorescein angiography and optical coherence tomography angiography; no signs of macular edema were present.The patient was treated with two intravitreal injections of anti-VEGF agents and with completion of scatter retinal photocoagulation. At her last follow-up (6 months later), shrinkage of FNV and resorption of the pre-retinal subhyaloid hemorrhage were documented by means of multimodal imaging.

Conclusions and importance: FNV is a rare clinical finding that can complicate retinal vascular disorders and can be effectively managed with good visual outcomes. Our case highlights the importance of multimodal imaging to diagnose FNV in retinal vaso-occlusive disorders and then to assess the response to treatment during the follow-up.

Keywords: Combined branch retinal vein and artery occlusion; Fluorescein angiography; Foveal neovascularization; Multimodal imaging; OCT angiography.