# Case Report: A rare case of combined branch retinal vein occlusion and branch retinal artery occlusion

## TL;DR

A rare case of combined retinal vein and artery blockage was successfully treated with anti-VEGF injections and laser therapy, improving vision and reducing swelling.

## Contribution

This case report highlights an effective treatment approach for a rare retinal condition involving both vein and artery occlusions.

## Key findings

- The patient's visual acuity improved from 20/125 to 20/40 after treatment.
- Macular thickness decreased significantly from 302 μm to 182 μm following therapy.
- Combination therapy with anti-VEGF and laser photocoagulation resolved intraretinal fluid.

## Abstract

The combination of branch retinal vein occlusion (BRVO) and branch retinal artery occlusion (BRAO) is extremely rare. At present, the pathogenic mechanism underlying the occurrence of combined BRVO and BRAO remains unclear. Prompt treatment of macular edema (ME) secondary to combined BRVO and BRAO with anti-vascular endothelial growth factor (anti-VEGF) therapy and laser photocoagulation can achieve a satisfactory prognosis.

This report presents a rare case of ME secondary to combined BRVO and BRAO treated with anti-VEGF agents and laser photocoagulation.

A 59-year-old man presented with a 3-month history of blurred vision in the left eye. The patient had a 5-year history of diabetes and hypertension. On examination, the best-corrected visual acuity (BCVA) was 20/20 in the right eye and 20/125 in the left eye, and the intraocular pressure in both eyes was within the normal range. Slit lamp examination revealed unremarkable anterior segments in both eyes, except for lens opacity. According to the fundus examination findings, a diagnosis of ME secondary to combined BRVO and BRAO in the left eye was established. The central macular thickness (CMT) in the left eye was 302 μm. The patient subsequently underwent angiography-guided sectoral laser photocoagulation and received intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents in the left eye. After 3 months of treatment, the BCVA in the left eye improved to 20/40, the CMT decreased to 182 μm, and the intraretinal fluid was resolved. Thereafter, the patient did not return to the clinic for further ophthalmic examinations.

Combined BRVO and BRAO is an uncommon and extremely rare retinopathy. Intravitreal injection of anti-VEGF drugs and laser photocoagulation are effective treatments for ME secondary to combined BRVO and BRAO. In addition, systemic evaluation and close monitoring of cardiovascular risk factors should not be overlooked.