[Retinal macroaneurysm as a cause of hemorrhage into the vitreous body]

Retinal macroaneurysms are often misdiagnosed. Although the vast majority of cases are symptom-free or lead to perianeurysmal exudates and bleeding, a few rare cases show rupture and bleeding into the vitreous body. In four patients who had been referred because of acute visual deterioration caused by a vitreous hemorrhage of unknown origin, the peripheral fundus could initially be examined ophthalmoscopally. Six weeks later, bleeding recurred in one eye, making examination impossible. Ultrasound examinations showed that the central retinae of all four eyes were not detached. In one case, a small, solid elevation close to the macula was observed at B-scan. Following spontaneous resorption of the vitreous hemorrhages, fluorescein angiography showed one macroaneurysm in each of two eyes and two macroaneurysms in the other two eyes, located in each case in the temporal arteries. Following laser treatment in 3 of the 4 cases, no further hemorrhages were observed in any of the patients over a follow-up period of 4 to 15 months.