Branch retinal artery occlusion (BRAO) is a common vascular occlusive disorder. BRAO involving the posterior pole is usually symptomatic, but occasionally has very limited clinical features. We describe 2 cases where the underlying pathology was initially unclear and the diagnosis therefore not reached at presentation. Use of the latest retinal imaging, spectral domain optical coherence tomography (SD-OCT) enabled correct diagnosis of BRAO. The images demonstrate and contrast the fine changes that can be seen in the acute and chronic phases of this condition and illustrate how the pathogenesis of BRAO is confined to the outer retinal layers. We believe the subtle presentations of this common condition that we discuss highlight how diagnosis of BRAO can often be challenging, but may be facilitated by the use of SD-OCT retinal imaging.
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