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Characterization of Vascular Morphology of Neovascular Age-Related Macular Degeneration by Indocyanine Green Angiography
Published on: August 11, 2023
Multiple retinal arterial macroaneurysms associated with submacular hemorrhage.
Eleni Papageorgiou1, Dimera Vasiliki, Dimitrios Koufakis
1Centre for Ophthalmology, University of Tübingen, Tübingen, Germany. eleni.papageorgiou@med.uni-tuebingen.de
European Journal of Ophthalmology
|February 28, 2012
Summary
This case study highlights an unusual instance of multiple retinal arterial macroaneurysms (RAMs) in a hypertensive woman. Early detection of these rare vascular lesions is crucial for preventing vision loss.
Area of Science:
- Ophthalmology
- Retinal Vascular Diseases
Background:
- Retinal arterial macroaneurysms (RAMs) are acquired vascular dilatations of retinal arteries.
- They are typically unilateral, solitary lesions, often associated with hypertension in older women.
Observation:
- A 64-year-old hypertensive woman presented with a dense submacular hemorrhage and vision loss (20/200).
- Fluorescein angiography identified four distinct retinal arterial macroaneurysms (RAMs) along a single inferotemporal arteriole.
- Optical coherence tomography confirmed RAM rupture without underlying choroidal abnormalities.
Findings:
- Despite refusing surgical intervention, the patient's vision improved to 20/70 over 3 months with partial hemorrhage resolution.
- However, the condition progressed to include vitreoretinal traction and neurosensory retinal detachment involving the macula.
Implications:
- This case represents the first reported instance of multiple (four) RAMs occurring on the same arteriole.
- The findings underscore the importance of regular ophthalmic examinations for hypertensive individuals to facilitate early diagnosis and management of RAMs.
- Prompt identification and treatment are essential for preventing irreversible vision impairment associated with RAMs.
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