PMC10377553_01
Case Report 1: At presentation: (A) Macular SD-OCT showing a parafoveal hyper-reflective band at the level of inner nuclear layer; (B) FAF showing venous engorgement and a fern-like pattern; (C) AF and ICGA without ischemic areas (time: 1.47.76). At 4th day of symptoms: (D) Macular SD-OCT showing a peripapillary edema and parafoveal subretinal fluid; (E) FAF showing a fern-like pattern at presentation; (F) AF and ICGA with non-perfused areas (time: 2.04.66). At 4th month of symptoms: (G) Macular SD-OCT showing a macular disorganization; (H) FAF with regression of the fern-like pattern; (I) AF and ICGA without ischemic areas (time: 1.52.66).
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Macular Spectral Domain - Optical Coherence Tomography (Macular SD-OCT) showed a parafoveal hyper-reflective band at the level of inner nuclear layer (shown in Figure 1A) and a Fundus Autofluorescence (FAF) revealing a fern-like pattern (Spectralis  OCT, version 1.10.2.0, Heidelberg Engineering, Heidelberg, Germany) (shown in Figure 1B), with no ischemia or vascular leakage on angiography on fluorescein angiography (FA) or indocyanine green angiography (ICGA) (shown in Figure 1C).  Table 2. This diagnosis was corroborated by clinical observation carried out on the 4th day of symptoms, with flame-shaped and dot hemorrhages adjacent to retinal veins and central retinal vein, peripapillary edema and nasal subretinal fluid (shown in Figure 1D), in addition to hyperreflectivity changes in the inner layers and the fern-like pattern already observed on the 1st day (shown in Figure 1E), without vascular leakage (shown in Figure 1F).  Although at fundoscopy, the retina still presented visible hemorrhages and macular disorganization with regression of the fern-like pattern (shown in Figure 1G and H) and without ischemia (shown in Figure 1I).
PMC10377553_02
Case Report 2: At presentation: (A) Retinography with inferior peripapillary pallor and slight periarterial edema; (B) Macular SD-OCT showing an edema of the inner layers of the retina adjacent to the inferior temporal branch of the central retinal artery. At 1st month of symptoms: (C) Macular SD-OCT maintaining an internal retinal edema; (D) AF showing dilation of peripapillary capillaries with ischemic lesions in the inferior temporal artery (time: 1.31.48); (E) 30-2 Visual Field showing the superior scotoma with preserved macula.
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In RE, pallor of the retina inferior to the optic disc was observed with preservation of the central macula (shown in Figure 2A) and macular SD-OCT showed an edema of the inner layers of the retina adjacent to the inferior temporal branch of the central retinal artery (shown in Figure 2B). At fundoscopy it was observed in RE inferior papillary pallor, with some cotton-wool exudates along the inferior temporal artery, with good foveal reflex and no visible hemorrhages; at macular SD-OCT (shown in Figure 2C), the inner retina maintained the edema of the inner layers of the retina adjacent to the inferior temporal branch of the central retinal artery; FA (shown in Figure 2D) showed an anatomical variant (bifurcation of the superior temporal artery with the inferior macular branch), dilation of peripapillary capillaries with ischemic lesions in the inferior temporal artery, with signs of reperfusion and no signs of peripheral ischemia and 30-2 visual field (Humphrey Field Analyzer: HFA, Carl Zeiss Meditec, Dublin, CA) (shown in Figure 2E) with superior visual field amputation and preserved macula.
PMC10377553_03
Case Report 3: At presentation: (A and B) Retinitis in the upper nasal macular region with intraretinal hemorrhages in retinography; (C) Macular SD-OCT showed macular edema; (D) - AF and ICGA showed an area of contrast diffusion in the superior temporal periarch (time: 1.04.26 and 6.48.54); (E) OCT-A showed area of non-perfusion in the upper nasal macula. At 1st month of symptoms: (F) Retinography with whitish lesion in the upper nasal macula; (G) OCT-A showed area of non-perfusion area in the upper nasal macula; (H) Macular SD-OCT showed macular edema. At 6th month of symptoms: (I) Retinography without hemorrhages or visible area of retinitis: (J and K) Area of vascular reperfusion without contrast diffusion on AF and ICGA (time: 0.27.87) and OCT-A; (L) No macular edema on Macular SD-OCT.
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On the mydriatic fundus, no changes were found in the LE; in the RE it was observed a well-defined whitish area adjacent to the superior temporal arcade, with intraretinal hemorrhages (shown in Figure 3A and B) (described in Table 1). Macular SD-OCT showed macular edema (shown in Figure 3C), FA and ICGA and Optical Coherence Tomography Angiography (OCT-A) showed an area of non-perfusion in the upper nasal macula (shown in Figure 3D and E). In the 1st month of follow-up, the patient s BCVA improved to 20/20 in the RE, and despite the maintenance of a whitish lesion in the upper nasal macula (shown in Figure 3F), a decrease in papillary hemorrhages was observed. Macular SD-OCT showed improvement of the macular edema and a smaller macular hyper-reflective lesion; OCT-A showed maintenance of non-perfusion area in the upper nasal macula (shown in Figure 3G and H). At fundoscopy, it was observed regression of the lesion in the upper nasal macula (shown in Figure 3I and J), with microvascular alterations and rare hemorrhages, a maintenance of non-perfusion area in the upper nasal macula (shown in Figure 3K) and macular SD-OCT showed no macular edema (shown in Figure 3L).
PMC10377553_04
Case Report 4: At presentation: (A) Retinography with superior temporal periarchal hemorrhage; (B and C) No macular edema on Macular SD-OCT but thickening of the inner layers of the retina at the site of bleeding. At 1st year of symptoms: (D) Retinography without hemorrhage; (E) Macular SD-OCT without edema.
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On objective examination, she had a BCVA 20/20 in both eyes, without changes at biomicroscopy; the fundoscopy was unremarkable on the RE but in the LE there were blurry hemorrhages near the superior temporal arcade, without macular involvement (shown in Figure 4A) (described in Table 1). In macular SD-OCT, there was thickening of the inner layers of the retina at the level of hemorrhage (shown in Figure 4B and C) without macular edema. One year after the diagnosis, she had BCVA 20/20 in both eyes and without fundoscopic changes (shown in Figure 4D and E).
PMC10377553_05
Case Report 5: At presentation: (A) Superior hemiretinal hemorrhage on Retinography; (B) Macular SD-OCT with patterned dystrophy of the retinal pigment epithelium but without macular edema; (C) AF with some ischemic areas in the upper retina with some contrast diffusion. At 6th month of symptoms: (D) Rare hemorrhage on Retinography; (E) Macular SD-OCT with patterned dystrophy of the retinal pigment epithelium but without macular edema.
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Table 1), without macular edema on macular SD-OCT (shown in Figure 5B). FA showed hypofluorescent spots due to blocking effect with slight contrast diffusion (shown in Figure 5C). Therefore, the most likely diagnostic hypothesis was a hemiretinal vein occlusion without macular edema. At LE fundoscopy, some hemorrhages were observed in the superior retina with some cotton-wool exudates (shown in Figure 5D); SD-OCT showed no macular edema (shown in Figure 5E).