Introduction. Branch retinal vein occlusion (BRVO) is a common retinal vascular condition that results in intraocular inflammatory changes. Ultra wide field fluorescein angiography (UWFFA) is a retinal imaging device that can capture peripheral retinal findings. The purpose of this study was to look for peripheral findings in the fellow eye of patients with BRVO using UWFFA. Methods. Retrospective imaging review of patients diagnosed with BRVO that had both eyes imaged with UWFFA. Images were graded for peripheral findings in other quadrants of the same eye as well as in all quadrants of the fellow eye. Results. Of 81 patients, 14 (17%) patients had late vascular leakage in a quadrant other than the BRVO distribution. Five (6%) findings were in the same eye, 8 (10%) findings were in the fellow eye, and 1 (1%) finding was in both the same eye and the fellow eye. Of these 14 patients, 11 (80%) patients had hypertension. Conclusion. Late peripheral retinal leakage in the fellow eye of patients with BRVO was detected in this cohort of patients with UWFFA. This novel finding may represent underlying systemic inflammation, hypertension, or bilateral BRVOs. 1. Introduction Branch retinal vein occlusion (BRVO) affects approximately 1% of the population and can cause severe vision loss through macular edema, retinal neovascularization, and retinal detachment [1–4]. The disease is estimated to be bilateral in 5% of patients at presentation and become bilateral in 15% of patients over time [3, 5]. When bilateral and/or multiple, systemic vasculitis such as sarcoidosis, systemic lupus erythematosus, or Behcet’s disease may be the underlying etiology. Atherosclerosis risk factors such as hypertension and hypercholesterolemia are thought to contribute to BRVO formation by causing arterial wall hardening and inflammation at arteriovenous crossing sites [6]. In theory, systemic risk factors should put patients at similar risk for BRVO in both eyes and it is unclear why the disease is typically unilateral. One explanation could be due to random and individual variation in arteriovenous crossing patterns [7]. There are several studies examining the vitreous of eyes that have suffered BRVO showing that there are increased inflammatory mediators when compared with control surgical patients. For example, vascular endothelial growth factor (VEGF), soluble intercellular adhesion molecule-1, interleukin-8, and interleukin-6 were among the inflammatory markers found to be elevated in the vitreous of BRVO eyes [8–10]. In these studies inflammatory markers were correlated to
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