RUPTURED RETINAL ARTERIAL MACROANEURYSM ON THE OPTIC DISK

To describe multimodal imaging findings in a patient presenting with an occult optic disk macroaneurysm.

A 54-year-old woman presented with decreased vision in the right eye secondary to preretinal, intraretinal, and optic disk hemorrhage.

Ancillary fluorescein angiography revealed evidence of an occult optic disk macroaneurysm that was not realized on fundoscopic examination. Subsequent optical coherence tomography obtained once the hemorrhage resolved demonstrated a thrombosed macroaneurysm with an adjacent ring of exudate.

Detection of optic disk macroaneurysms at the time of initial presentation can be difficult because of concurrent overlying hemorrhage, but should nevertheless be kept in the differential when macular hemorrhage in multiple retinal layers is observed.