Maculopexy Resolves Cystic Macular Edema After Branch Retinal Vein Occlusion

PURPOSE: Using retrospective data, we demonstrate a technique of grid laser retinopexy together with vitrectomy and gas tamponade (pneumatic maculopexy) to permanently resolve branch retinal vein occlusion (BRVO)-related cystoid macular edema (CME). METHODS: After laser ablation to ischemic peripheral retina, and six months of unsuccessful medical therapy with intravitreal bevacizumab injections, we performed vitrectomy with grid laser treatment to superotemporal macular edema, and C3F8 15% gas tamponade (pneumatic maculopexy). RESULTS: Immediately after resolution of gas tamponade all CME had resolved, and visual acuity had improved from 20/40 to 20/30. Twenty-four months after vitrectomy and without further therapy, visual acuity had improved to 20/25 and the macula remained dry. CONCLUSION: When medical therapy is insufficiently effective, maculopexy by grid laser combined with intravitreal drying agents and/or gas tamponade can achieve long-term resolution of cystoid macular edema in selected cases. Parafoveal laser treatment must be precisely performed.