Retinal veno-venous anastomosis in chronic branch retinal vein occlusion: when natural healing takes place

It was a 63-year-old woman with a positive history of systemic hypertension consulting for a three years history of blurred vision Oculus Dexter (OD). She noticed a slowly progressive spontaneous improvement and denied any previous ophtalmology consultation. Best-corrected visual acuity was 6/18 OD with unremarkabale adnexal and anterior segment examination. Fundus examination showed showing supero-tempral branch retinal vein occlusion with arterio-venous nicking, macular exudates, and numerous retinal venovenous anastomoses bridging the horizontal raphe temporally. The fellow eye was normal. We ordered a fluorescein angiography with color and monochromatic photography that highlighted the previous findings and showed macular diffusion in early and late phases (A,B,C,D). We retained the diagnosis of retinal venovenous anastomosis in chronic branch retinal vein occlusion with chronic macular edema. The patient preferred observation of her condition and refused further investigations or interventions. After two years of follow-up, her visual acuity was stable. We insisted on medical control of her systemic hypertension.