• Courtesy of Gary Brown, MD.
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    The fundus appearance of a branch retinal vein occlusion is similar to that of a central retinal vein occlusion, except that only the area drained by the occluded vein will show retinal hemorrhages. Nerve-fiber- layer infarcts (cotton-wool spots or soft exudates) may be seen as a consequence of capillary occlusions within the distribution of the vein occlusion. Lipids (hard exudates) also may be seen in the distribution of the vein occlusion within areas of damaged capillaries where microaneurysms or retinal telangiectasis develops. This slide shows such an occlusion with involvement of the superotemporal vein. Laser surgery is indicated for macular edema that does not resolve and for neovascularization (which otherwise could lead to hemorrhage into the vitreous or tractional detachment of the retina as seen from retinal neovascularization in diabetic patients) or, less commonly, iris or angle neovascularization (more commonly seen following a central vein occlusion), which could lead to vision loss and pain from glaucoma (termed neovascular glaucoma). As with central retinal vein occlusions, there is an association with hypertension in patients with branch retinal vein occlusions.