Fig. 4

a. Left eye of a 41-year old male patient with inferior macular BRVO. A. Color fundus photo and FFA show the pathological arterio-venous crossing involving a tributary of the infero-temporal venous arcade (black arrow). The posterior pole shows multiple whitish rounded lesions in the para-foveal area (white arrows). The corresponding FFA shows relative hypofluorescence though no angiographic evidence of CNP, which parenthetically points to hypoperfusion of the DCP that is not delineated by FFA. Note that the FAZ is unremarkable on FFA. b. Corresponding SS-OCT radial scan shows multiple hyperreflective bands at the level of the INL in the para-foveal area, pathognomonic of para-central acute middle maculopathy (PAMM) lesions. c. Corresponding en-face SS-OCTA image in a 6 × 6 mm field. Note that the SCP and the FAZ are rather unremarkable. d. Corresponding en-face SS-OCT image in a 6 × 6 mm field shows the para-foveal whitish lesions seen in the color photo located at a deeper plane relative to the SCP. e. Corresponding flow-density map of the SCP in a 6 × 6 mm field. f. Corresponding en-face SS-OCTA image of the DCP. Note that all 4 quadrants show generalized vascular rarefaction and the peculiar hyperintense signal in the para-foveal area corresponding to the location of the PAMM lesions and denoting severe ischemia of the DCP. The hyperintense signal could be explained by overcrowding of vessels in the para-foveal area due to displacement by PAMM lesions or due to compensatory vasodilation secondary to ischemia. g. Corresponding en-face SS-OCT image at the level of the DCP in a 6 × 6 mm field. Note that the PAMM lesions with their characteristic fern-like pattern are best delineated at this plane. H. Corresponding flow-density map of the DCP in a 6 × 6 mm field