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Intraretinal Macroaneurysms and Multimodal Imaging: A Retrospective Analysis
Mustafa Kayabaşı1, Seher Köksaldı2, Ahmad M Mansour3
1Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey.
Purpose:
To analyze the multimodal imaging characteristics of intraretinal macroaneurysms.
Patients And Methods:
Intraretinal aneurysms larger than 150 μm in diameter on fluorescein angiography were termed as intraretinal macroaneurysm and grouped as primary and secondary according to the absence or presence of any coexisting posterior segment diseases.
Results:
A total of 20 intraretinal macroaneurysms were observed in 18 eyes of 18 patients. Mean age of the cohort was 65.44 ± 9.14 years (Range; 49-82 years). Mean diameters of intraretinal macroaneurysms were 238.20 ± 61.12 μm (Range; 163.00-292.50 μm) and 242.72 ± 49.58 μm (Range; 168.00-328.00 μm) on fluorescein angiography and optical coherence tomography, respectively. Primary group had 10 eyes with 11 intraretinal macroaneurysms, whereas eight eyes had nine intraretinal macroaneurysms in the secondary group. Three of the eight eyes (37.5%) had diabetic retinopathy, four (50%), retinal vein occlusion, and one (12.5%), posterior uveitis in the secondary group. No statistically significant differences were found between the two groups in terms of age, sex, presence of intraretinal or subretinal fluid, the mean age, the mean central macular thickness, the mean distance of intraretinal macroaneurysms from the fovea, the mean diameter of intraretinal macroaneurysms measured on fluorescein angiography, and the mean diameter of intraretinal macroaneurysms measured on optical coherence tomography. Presence of intraretinal fluid was significantly more frequent than the presence of subretinal fluid in all eyes (p = 0.004).
Conclusion:
Intraretinal macroaneurysms are diagnosed more and more with the utilization of multimodal imaging techniques. We propose a simple classification system in order to help achieving a standardized terminology and ensure consistent understanding. The classification can be simplified as primary or secondary intraretinal macroaneurysm according to the absence or presence of the associated posterior segment disorders.
Insights
Multimodal imaging reveals intraretinal macroaneurysms (IMs) are increasingly diagnosed. A simple classification system distinguishes primary IMs from secondary IMs based on coexisting posterior segment diseases.
Area of Science:
- Ophthalmology
- Medical Imaging
- Retinal Diseases
Background:
- Intraretinal macroaneurysms (IMs) are vascular abnormalities in the retina.
- Advancements in multimodal imaging techniques facilitate their detection.
- Standardized classification is needed for consistent diagnosis and understanding.
Purpose of the Study:
- To analyze the multimodal imaging characteristics of intraretinal macroaneurysms.
- To propose a simple classification system for IMs.
Main Methods:
- Intraretinal aneurysms >150 μm on fluorescein angiography were defined as IMs.
- IMs were categorized as primary (no coexisting posterior segment diseases) or secondary (with coexisting diseases).
- Multimodal imaging, including fluorescein angiography and optical coherence tomography, was utilized.
Main Results:
- Twenty IMs were observed in 18 patients (mean age 65.44 years).
- Mean IM diameters were similar on fluorescein angiography (238.20 μm) and OCT (242.72 μm).
- Intraretinal fluid was significantly more frequent than subretinal fluid (p=0.004).
Conclusions:
- Intraretinal macroaneurysms are increasingly diagnosed with multimodal imaging.
- A proposed classification simplifies IMs into primary or secondary types.
- This classification aids standardized terminology and consistent understanding of IMs.
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