title: [Isolated patchy perivenular whitening: When white edema of the posterior pole may be vascular in origin but not a retinal artery occlusion].
abstract: OBJECTIVE
  To identify cases of non-ischemic retinal vein occlusion (RVO) presenting as isolated patchy perivenular retinal whitening and to describe diagnostic considerations and short-term natural history.
  
  
  METHODS
  Retrospective observational monocentric case series. Patients monitored in one center between January 2013 and January 2015. Among the 151 patients monitored in our center for retinal vein occlusion, we identified patients presenting with isolated patchy perivenular whitening revealing retinal venous occlusion.
  
  
  RESULTS
  Eight patients presenting with isolated perivenular whitening revealing RVO were identified (3.9 %). There were five central retinal vein occlusions, three hemi-retinal vein occlusions and no branch retinal vein occlusions. Initial visual acuity was preserved in five out of eight cases. In all cases, patchy perivenular whitening was isolated, without retinal hemorrhage. Blue monochromatic photographs allowed visualization of patchy perivenular whitening in all cases. Optical coherence tomography (OCT) showed a focal and segmental hyper-reflective area in the inner retinal layers, especially in the inner nuclear layer. One month after diagnosis, atrophy was noted in the retinal layers showing initial hyper-reflectivity. Three cases of our series of eight were initially mistakenly diagnosed as central retinal arterial occlusion.
  
  
  CONCLUSIONS
  The main complication of perivenular whitening is the atrophy of inner retinal layers responsible for paracentral scotomas. The differential diagnosis with retinal arterial occlusion, which may be difficult, is based on the angiographic and OCT features, and their progression.
authors.affiliation: Unité de rétine, service d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse, France; Service d'ophtalmologie, centre hospitalier de Bigorre, boulevard de Lattre-de-Tassigny, 65000 Tarbes, France. Electronic address: jeannelajoie@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Lajoie
authors.affiliation: Unité de rétine, service d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse, France.
authors.forename: A
authors.initials: A
authors.lastname: Renouvin
authors.affiliation: Unité de rétine, service d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse, France.
authors.forename: L
authors.initials: L
authors.lastname: Mahieu
authors.affiliation: Unité de rétine, service d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse, France.
authors.forename: C
authors.initials: C
authors.lastname: Tolou
authors.affiliation: Unité de rétine, service d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse, France.
authors.forename: C
authors.initials: C
authors.lastname: Suarez
authors.affiliation: Unité de rétine, service d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse, France.
authors.forename: S
authors.initials: S
authors.lastname: Ouardani
authors.affiliation: Unité de rétine, service d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse, France.
authors.forename: S
authors.initials: S
authors.lastname: Hamid
authors.affiliation: Unité de rétine, service d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse, France.
authors.forename: M
authors.initials: M
authors.lastname: Cassagne
authors.affiliation: Unité de rétine, service d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse, France.
authors.forename: V
authors.initials: V
authors.lastname: Pagot-Mathis
authors.affiliation: Service d'ophtalmologie, hôpital de la Timone, université d'Aix-Marseille - AP-HM, 13385 Marseille, France.
authors.forename: F
authors.initials: F
authors.lastname: Matonti
authors.affiliation: Unité de rétine, service d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU de Toulouse, place Baylac, 31059 Toulouse, France.
authors.forename: V
authors.initials: V
authors.lastname: Soler
mesh_terms: D000328:Adult; D000368:Aged; D001284:Atrophy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology; D015356:Retinal Artery Occlusion / Q000175:diagnosis; D012170:Retinal Vein Occlusion / Q000175:diagnosis* / Q000473:pathology; D012171:Retinal Vessels / Q000473:pathology*; D012189:Retrospective Studies; D012607:Scotoma / Q000209:etiology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014794:Visual Fields
keywords: Blanc périveinulaire; Central retinal vein occlusion; OCT; Occlusion artérielle rétinienne; Occlusion de veine centrale de rétine; Occlusion veineuse rétinienne; Perivenular whitening; Retinal arterial occlusion; Retinal vein occlusion