[Retinal arterial macroaneurysms]

Nineteen eyes of 17 patients were examined for complications associated with a retinal macroarterial aneurysm. 13 of 17 patients were feminine and over 70 years of age and 15 had longstanding systemic hypertension. Visual loss associated with retinal macroarterial aneurysms was related to macular hemorrhage, exudate, or serous retinal detachment. Twelve eyes had retinal hemorrhages associated with the macroarterial aneurysm. Hemorrhages were subretinal and/or preretinal of which some diffused into the vitreous. Seven eyes were treated by direct argon laser photocoagulation of the aneurysm giving an arterial occlusion. Five eyes received perianeurysmal photocoagulation without occlusion of the arteriole. Five eyes received no laser treatment because their exudate or hemorrhage was not threatening the fovea and these evolved towards cicatrisation without a drop in visual acuity. Improvement in visual acuity was noted with both types of photocoagulation. But, direct photocoagulation was found less preferable since an absolute scotoma may be created by the area deprived of arterial flow. Perianeurysm photocoagulation was found to be effective, and is indicated in cases of deep exudate and edema that may threaten the fovea. Treatment is questionable when hemorrhage is the predominant complication.