Retinal arteriolar macroaneurysms overlying the optic nerve

Retinal arteriolar macroaneurysms typically involve the second and third order arterioles. Macroaneurysms involving the first order arterioles, specifically overlying the optic nerve, have been infrequently reported.

This is a retrospective case series.

Two patients were found to have an arteriolar macroaneurysm overlying the optic nerve. The first, a 77-year-old man, had focal laser photocoagulation to the macroaneurysm. The second, a 75-year-old woman, had spontaneous resolution of the lesion without treatment. Final visual acuity was 20/25 in the treated patient compared to 20/80 in the untreated patient.

Retinal arteriolar macroaneurysms overlying the optic nerve will involute spontaneously or as a result of focal laser photocoagulation. The associated macular edema may result in permanent visual loss. Focal laser treatment over the optic nerve did not cause optic nerve damage.