Precipitation of hard exudate after resorption of intraretinal edema after treatment of retinal branch vein occlusion.

Abstract

To present evidence that precipitation of hard exudate in the retina can occur after reduction of macular edema by successful photocoagulation treatment for retinal branch vein occlusion. A 59-year-old woman received argon laser retinal photocoagulation treatment for retinal branch vein occlusion over the primarily involved engorged area of the retina. Fundus changes were documented by fundus photography and optical coherence tomography. Before treatment, an extensive intraretinal edema with cavity formation and a small serous foveal detachment extended outside the engorged area of the retina. Three months after treatment, all retinal thickening had disappeared, but a markedly increased amount of intraretinal hard exudate was seen adjacent to the treated area. Precipitation of hard exudate can occur after reduction of macular edema by successful retinal photocoagulation treatment, presumably because water and highly soluble electrolytes are resorbed faster than lipids. This phenomenon should be distinguished from accumulation of hard exudate resulting from disease progression.