title: Massive macular hard exudates associated with branch retinal vein occlusion.
abstract: OBJECTIVE
  To report four cases of branch retinal vein occlusion (BRVO) with the complication of serous retinal detachment (SRD).
  
  
  METHODS
  We retrospectively studied four eyes of four patients with macular edema and macular hard exudates associated with midperipheral BRVO. Visual acuity, ophthalmoscopy, fluorescein angiography, and optical coherence tomography findings were evaluated. Three of the four eyes underwent laser photocoagulation in the BRVO area 1 month after the initial visit.
  
  
  RESULTS
  Macular edema consisted of SRD without cystoid macular edema in all eyes. Late-phase fluorescein angiography showed extensive dye leakage in the BRVO area. When SRD was resolved 4 months after the initial examination, hard exudates had increased in the macular area. Although macular hard exudates decreased 1 year after the initial examination, visual acuity remained under 20/20 because of macular atrophy.
  
  
  CONCLUSIONS
  SRD is one type of macular edema observed in BRVO. In macula-spared midperipheral BRVO, the SRD originates from a vascular leaking area, and there is a high risk that massive macular hard exudates will develop, which may affect visual recovery.
authors.affiliation: Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan. kyotaka@showa.gunma-u.ac.jp.
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kashima
authors.affiliation: Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kishi
mesh_terms: D000368:Aged; D005122:Exudates and Transudates; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D017075:Laser Coagulation; D008266:Macula Lutea / Q000473:pathology*; D012163:Retinal Detachment / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D012170:Retinal Vein Occlusion / Q000150:complications* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity