Retinal arterial macroaneurysm: a case report

Retinal arterial macroaneurysms are an acquired retinal vascular abnormality. These isolated dilatations of the major retinal arterial branches are found within the posterior pole and are associated with systemic hypertension, arteriosclerosis, retinal emboli and cardiovascular disease.

Although many patients are asymptomatic, vision loss is the most commonly manifested symptom. Vision loss may occur as a result of hemorrhage (subretinal, intraretinal, preretinal or vitreous) or macular edema with associated lipoprotein exudation. Most lesions spontaneously involute without causing any visual consequence. If central vision is reduced or threatened, laser photocoagulation may be applied directly to the macroaneurysm itself or to affected retinal capillary beds. While retinal arterial macroaneurysms frequently manifest as isolated phenomena with few symptoms (loss of visual acuity if bleeding or exudation encroaches on the macula), their differential diagnosis includes retinal and systemic diseases that require thorough investigation.

Optometrists should be familiar with the signs and symptoms of retinal arterial macroaneurysms, their differential diagnosis, workup, and management.