Vol 2, No 3 (2017)
Case report
Published online: 2017-12-28

open access

Page views 1092
Article views/downloads 1001
Get Citation

Connect on Social Media

Connect on Social Media

Wet age-related macular degeneration combined with branch retinal vein occlusion

Ioannis Mallias1, Panagiota Mylova, Anastasia Tassiopoulou
Ophthalmol J 2017;2(3):87-90.


To disclose a case of wet age-related macular degeneration (wet AMD) combined with branch retinal vein occlusion (BRVO). The prognosis and the treatment are discussed. A 77-year-old woman presented with wet AMD of the left eye. The patient was treated with intravitreal injection of ranibizumab of the left eye with improvement of visual acuity and resolution of intra-retinal and sub-retinal fluid. One year after the last injection the patient developed a BRVO of the same eye. A flame shaped haemorrhage was observed, and OCT examination showed cystic macular oedema. Fluorescein angiography showed that there was an active lesion of choroidal neovascularisation (CNV), areas of ischaemia, delayed filling and emptying of the affected vein, micro aneurisms, and telangiectatic changes. The co-existence of BRVO and active WET AMD was documented by fluorescein angiography. The co-existence of both diseases has not been described in the literature until today. This co-existence makes the prognosis worse and diminishes the patient’s visual acuity.

Article available in PDF format

View PDF Download PDF file


  1. Klein R, Klein B, Linton K. Prevalence of age-related aaculopathy. Ophthalmology. 1992; 99(6): 933–943.
  2. Leibowitz H, Krueger DE, Maunder LR, et al. The Framingham Eye Study Monograph: An ophthalmological and epidemiological study of cataract, glaucoma, diabetic retinopathy, macular degeneration and visual acuity in a general population of 2631 adults. Surv Ophthalmol. 1980; 24: 335–610.
  3. Clemons TE, Milton RC, Klein R, et al. Age-Related Eye Disease Study Research Group. Risk factors for the incidence of Advanced Age-Related Macular Degeneration in the Age-Related Eye Disease Study (AREDS) AREDS report no. 19. Ophthalmology. 2005; 112(4): 533–539.
  4. Khan JC, Thurlby DA, Shahid H, et al. Genetic Factors in AMD Study. Smoking and age related macular degeneration: the number of pack years of cigarette smoking is a major determinant of risk for both geographic atrophy and choroidal neovascularisation. Br J Ophthalmol. 2006; 90(1): 75–80.
  5. Smailhodzic D, Muether PS, Chen J, et al. Cumulative effect of risk alleles in CFH, ARMS2, and VEGFA on the response to ranibizumab treatment in age-related macular degeneration. Ophthalmology. 2012; 119(11): 2304–2311.
  6. Friedman DS, Katz J, Bressler NM, et al. Racial differences in the prevalence of age-related macular degeneration: the Baltimore Eye Survey. Ophthalmology. 1999; 106(6): 1049–1055.
  7. Sandberg MA, Tolentino MJ, Miller S, et al. Hyperopia and neovascularization in age-related macular degeneration. Ophthalmology. 1993; 100(7): 1009–1013.
  8. Huang D, Swanson EA, Lin CP, et al. Optical coherence tomography. Science. 1991; 254(5035): 1178–1181.
  9. Argon laser photocoagulation for senile macular degeneration. Results of a randomized clinical trial. Arch Ophthalmol. 1982; 100(6): 912–918.
  10. Argon laser photocoagulation for neovascular maculopathy. Three-year results from randomized clinical trials. Macular Photocoagulation Study Group. Arch Ophthalmol. 1986; 104(5): 694–701.
  11. Hayreh SS. Ocular vascular occlusive disorders: natural history of visual outcome. Prog Retin Eye Res. 2014; 41: 1–25.
  12. Risk factors for branch retinal vein occlusion. The Eye Disease Case-control Study Group. Am J Ophthalmol. 1993; 116(3): 286–296.
  13. Kolar P. Risk factors for central and branch retinal vein occlusion: a meta-analysis of published clinical data. J Ophthalmol. 2014; 2014: 724780.
  14. Argon laser photocoagulation for macular edema in branch vein occlusion. The Branch Vein Occlusion Study Group. Am J Ophthalmol. 1984; 98(3): 271–282.
  15. Argon Laser Scatter Photocoagulation for Prevention of Neovascularization and Vitreous Hemorrhage in Branch Vein Occlusion. Archives of Ophthalmology. 1986; 104(1): 34.
  16. McAllister IL, Vijayasekaran S, Chen SD, et al. Effect of triamcinolone acetonide on vascular endothelial growth factor and occludin levels in branch retinal vein occlusion. Am J Ophthalmol. 2009; 147(5): 838–46, 846.e1.
  17. Yoshimura T, Sonoda Kh, Sugahara M, et al. Comprehensive analysis of inflammatory immune mediators in vitreoretinal diseases. PLoS One. 2009; 4(12): e8158.
  18. Noma H, Funatsu H, Yamasaki M, et al. Pathogenesis of macular edema with branch retinal vein occlusion and intraocular levels of vascular endothelial growth factor and interleukin-6. Am J Ophthalmol. 2005; 140(2): 256–261.
  19. Karia N. Retinal vein occlusion: pathophysiology and treatment options. Clin Ophthalmol. 2010; 4: 809–816.
  20. Kolar P. Risk factors for central and branch retinal vein occlusion: a meta-analysis of published clinical data. J Ophthalmol. 2014; 2014: 724780.
  21. Chen X, Rong SS, Xu Q, et al. Diabetes mellitus and risk of age-related macular degeneration: a systematic review and meta-analysis. PLoS One. 2014; 9(9): e108196.