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Retinal Arterial Macroaneurysms: Clinical Features, Management, and Outcomes
Charles Zhang1, Katherine E Bowers2, Saara Khan2
1Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida.
Ophthalmology. Retina
|June 6, 2026
Summary
Retinal arterial macroaneurysms (RAM) often resolve spontaneously. While observation is common, early treatment may accelerate RAM resolution in severe cases.
Area of Science:
- Ophthalmology
- Retinal Vascular Diseases
- Medical Retina
Background:
- Retinal arterial macroaneurysms (RAM) are dilations of retinal arteries, often associated with hypertension.
- Management strategies range from observation to various treatment modalities.
- Understanding outcomes is crucial for guiding clinical decisions.
Purpose of the Study:
- To compare baseline characteristics, management, and long-term outcomes of eyes with RAM.
- To evaluate outcomes in contemporary cohorts managed with observation versus early treatment.
Main Methods:
- Retrospective cohort study of adult patients diagnosed with RAM.
- Data included demographics, ocular findings, OCT imaging, treatments, and visual acuity.
- Statistical analysis used t-tests, Wilcoxon signed-rank tests, chi-square, and Fisher's exact tests.
Main Results:
- 161 eyes (156 patients) were analyzed; 68% observed, 32% treated.
- The treatment cohort had worse initial BCVA and more macula hemorrhage (P<0.0024).
- RAM resolution occurred in 100% of eyes in both groups; treatment expedited resolution (362 vs 536 days, P=0.0170).
Conclusions:
- Most RAM cases improve spontaneously.
- Selective early treatment may be beneficial for eyes with severe initial presentations.
- Observation is a viable strategy, but treatment can accelerate resolution.
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