Retinal macroaneurysms: the natural history in four patients

Macroaneurysms of the retinal arterioles are a clinical entity distinct from the aneurysmal dilations associated with Coats' disease, Leber's disease, Eales' disease, and angiomatosis retinae. The pathogenesis is not completely understood, but they are closely associated with systemic hypertension, generalized atherosclerosis, and age. Macroaneurysms have been classified into three major groups: exudative, hemorrhagic, and quiescent. Four examples of macroaneurysms are presented with photographic documentation. The clinical appearance, natural history, complications, and management of this retinal entity are discussed.