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[Clinical and progressive features of macular hemorrhage secondary to retinal artery macroaneurysms]

I Zghal-Mokni1, L Nacef, B Yazidi

  • 1Institut Hedi Raies d'Ophtalmologie, Tunis, Tunisia. imen.zghal@rns.tn

Journal Francais D'Ophtalmologie
|February 24, 2007
PubMed
Abstract

Insights

Retinal arterial macroaneurysm (RAM) rupture can cause vision loss. Nd:Yag laser treatment improved outcomes for premacular hemorrhage, while subretinal hemorrhage cases resolved spontaneously.

Area of Science:

  • Ophthalmology
  • Vascular Medicine
  • Retinal Diseases

Background:

  • Retinal arterial macroaneurysm (RAM) is an acquired vascular abnormality in the macula.
  • Ruptured RAM can lead to significant vision decrease due to bleeding or exudation.
  • Complications include premacular, submacular, or vitreous hemorrhage, with subretinal hemorrhage often having a poor visual prognosis.

Observation:

  • Four patients (39-65 years) presented with sudden unilateral decreased visual acuity.
  • Ophthalmologic examination, fluorescein angiography, and funduscopy were used for diagnosis.
  • Hemorrhage locations included subretinal, preretinal, and combined preretinal/subretinal.

Findings:

  • Fluorescein angiography confirmed RAM with hyperfluorescent arterial dilatation.
  • Submacular hemorrhages resolved spontaneously with monitoring, achieving final visual acuity of 4/10 and 5/10.
  • Premacular subhyaloid hemorrhage treated with Nd:Yag laser hyaloidotomy resulted in final visual acuity of 5/10 and 7/10.

Implications:

  • Nd:Yag laser treatment can improve visual prognosis in premacular hemorrhage.
  • Subretinal hemorrhage may resolve favorably without intervention.
  • Surgical intervention for RAM-related hemorrhage should not be routine; further comparative studies are needed.

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