Retinal Macroaneurysm


Description

Retinal arterial macroaneurysms, which can be hemorrhagic or exudative, are acquired focal dilations of retinal arterial branches (mainly second-order retinal arterioles).

There is a 10% prevalence of bilateral illness, and several aneurysms can occasionally occur in the same eye.

Symptoms

However, if the central macula is unaffected, the patient might not exhibit any symptoms. Asymptomatic aneurysms are those that first appear without exudation or hemorrhage.

The majority of individuals with macroaneurysms first have rapid, painless vision loss in one eye.
Book an appointment with your Ophthalmologist who might refer you to a cardiologist if you experience any of these symptoms.


Causes

Similar age-related arteriosclerotic changes in the artery walls throughout the body are visible in the thickening of the vessel wall. Increased intimal remodeling and increased permeability of the vessels might result from localized ischemia brought on by vascular disease that damages the arterial walls, predisposing the vessel to dilatation.

There is a substantial correlation between hypertension and being elderly and female, which constitute the majority of people affected.

Diagnostics

To establish the diagnosis of a retinal macroaneurysms, your vitreo retinologist will do tests like:

Macroscopic aneurysms can be seen using fluorescein angiography.
Laboratory tests may reveal higher serum lipid levels.
Ultrasonography: Similar to the B-scan (and maybe the A-scan), ultrasonography may be recommended to rule out further conditions.
Histology: Similar to vascular malformations
Optically Coupled Tomography


Treatment

Laser photocoagulation: Moderate-intensity laser photocoagulation can be used to directly treat complicated retinal artery macroaneurysms.
Laser hyaloidotomy: Pneumatic dislodgment of the clot can be used to treat cases of submacular hemorrhage. A posterior hyaloidotomy can be performed in premacular hemorrhage patients using a YAG laser, releasing the bleeding into the vitreous for quicker clearing.
Anti-VEGF medications such as ranibizumab and bevacizumab may be utilized for patients who have macular edema caused by macroaneurysms.

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