Subretinal Hemorrhage Associated With Branch Retinal Vein Occlusion

Abstract

Purpose: : To study the pathomorphology of the subretinal hemorrhage (SRH) seen in eyes with branch retinal vein occlusion (BRVO) and its association with visual function.

Methods: : We reviewed retrospectively the medical records of 42 consecutive patients (42 eyes) with BRVO that affected the fovea. Retinal structural changes were examined by optical coherence tomography (OCT).

Results: : Of the 42 eyes, 34 showed cystoid spaces and 35 showed serous retinal detachment in the foveal area. On OCT sections, 19 of the 34 eyes with foveal cystoid spaces showed hemorrhage within these spaces and 18 of the 35 eyes with a foveal serous retinal detachment had accompanying SRH. More detailed OCT examination revealed that the hemorrhage within the foveal cystoid spaces appeared to be connected to the SRH through the external boundary of the retina in some eyes. While initial detection of foveal SRH and hemorrhage within the foveal cystoid spaces had no correlation with initial visual acuity (VA) (r = 0.109, P = 0.490; r = 0.243, P = 0.121), it was correlated with poorer final VA (r = 0.361, P = 0.019; r = 0.459, P = 0.002). After multiple regression analysis, foveal SRH at the initial visit was correlated marginally with final VA (ß = 0.279, P = 0.061). Our patients were classified into two groups by the initial detection of foveal SRH, and initial VA was not different between these two groups. At the final examination, lengths of the damage to the foveal photoreceptor layer were significantly longer in the SRH positive group than in the SRH negative group (P = 0.004), and final VA in the SRH positive group was significantly worse than that in the SRH negative group (P = 0.019).

Conclusions: : Foveal SRH is not an uncommon feature of BRVO and may cause subsequent damage to the foveal photoreceptor layer, resulting in poor visual function even after resolution of the retinal edema and retinal hemorrhage.

Keywords: retinal detachment