[Visual prognosis and macular pathology in eyes with retinal macroaneurysms]

We studied retrospectively the visual outcome of 20 eyes of 19 patients with symptomatic retinal arterial macroaneurysm. The macular pathology responsible for the acute visual loss was categorized as macular edema (5 eyes), preretinal hemorrhages alone (3 eyes), subretinal hemorrhages with or without preretinal hemorrhages (10 eyes) and vitreous hemorrhage (2 eyes). Thirteen eyes were treated with argon or dye laser photocoagulation. Five eyes with preretinal hemorrhage underwent YAG laser photodisruption of the posterior hyaloid membrane to release the preretinal hemorrhage into the vitreous space. Five eyes with macular edema, 3 eyes with preretinal hemorrhage without subretinal hemorrhage and 2 eyes with vitreous hemorrhage showed final vision of 0.5 or better, but of the other 10 eyes with subretinal hemorrhage with or without preretinal hemorrhage, 9 showed final visual acuity of 0.2 or worse. Visual prognosis of submacular hemorrhage due to ruptured retinal macroaneurysm is poor, but that of macular edema, preretinal hemorrhage or vitreous hemorrhage is relatively good.