Clinical characteristics of retinal arterial macroaneurysms and prognosis of different interventions

Chen, He; Zhao, Xinyu; Meng, Lihui; Zhang, Wenfei; Chen, Youxin

doi:10.1007/s00417-021-05364-0

Cited by 12 publications

(15 citation statements)

References 35 publications

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“…Anti-VEGF therapies have been found to be beneficial in the treatment of exudative RAMs, although the association between increased VEGF levels and RAMs has not been reported. 12 Although in our patient the association of the RAM and HNPCC/Lynch syndrome could have been coincidental, the RAM had an atypical presentation worth noting. Panton et al 3 describe 43 patients with RAM, of which approximately 80% had associated hypertension.…”

Section: Discussionmentioning

confidence: 59%

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Retinal Arterial Macroaneurysm in a Patient With Lynch Syndrome

Sood

Friedman

2023

Journal of VitreoRetinal Diseases

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Purpose: To describe a case of retinal arterial macroaneurysm (RAM) in a patient with hereditary nonpolyposis colon cancer (HNPCC)/Lynch syndrome. Methods: A case and its findings were analyzed. Results: A 68-year-old woman presented with a recent history of decreased near vision in the left eye. Both eyes had a visual acuity of 20/20 with normal intraocular pressure. The right retina was normal. The left retina had a focal dilation of the retinal arteriole with a surrounding hemorrhage and lipid in the inferonasal quadrant. The patient was diagnosed with RAM and was subsequently treated with focal laser photocoagulation. The patient had a medical history of stage 1 colon cancer associated with HNPCC/Lynch syndrome. Conclusions: Increased vascular network complexity has been reported in HNPCC/Lynch syndrome. This is the first report of a RAM in a patient with this genetic profile. Given the atypical presentation, there may be an association between HNPCC/Lynch syndrome and RAMs.

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Section: Discussionmentioning

confidence: 59%

“…Anti-VEGF therapies have been found to be beneficial in the treatment of exudative RAMs, although the association between increased VEGF levels and RAMs has not been reported. 12…”

Section: Discussionmentioning

confidence: 99%

Retinal Arterial Macroaneurysm in a Patient With Lynch Syndrome

Sood

Friedman

2023

Journal of VitreoRetinal Diseases

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“…4 Hemorrhagic RAMs are believed to have an incidence of 1:4,500 eyes per lifetime, thus represent a more common disease process than many other etiologies associated with BALAD, and there are no current management guidelines. 5 Pars plana vitrectomy with subretinal tPA injection was performed for the patient in Case 1, and the outcome was very favorable, but this only represents one case. Case 3 involved intravitreal injection of tPA and SF 6 , and also had a favorable visual outcome.…”

Section: Discussionmentioning

confidence: 98%

“…3 Retinal arterial macroaneurysms (RAMs) are dilatations of the first three branches of retinal arteries and represent a known complication of hypertensive retinopathy. 5 Retinal arterial macroaneurysms are believed to have an incidence of roughly 1:4,500 in the adult population, 6 and approximately half of these patients develop hemorrhagic RAMs. 5 Of note, hemorrhagic RAMs are one of the few causes of concurrent subretinal, intraretinal, and preretinal/vitreous hemorrhage.…”

mentioning

confidence: 99%

Ruptured Retinal Arterial Macroaneurysms Associated with Hemorrhagic Bacillary Layer Detachments

Doobin

Sharma

Horowitz

2022

RETINAL Cases &Amp; Brief Reports

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Background/Purpose: Bacillary layer detachments (BALAD) are a recently recognized form of retinal detachment involving a splitting of photoreceptors at the inner segment myoid zone, with separation of the external limiting membrane and ellipsoid zone on optical coherence tomography (OCT). A growing number of disease processes are recognized to cause BALAD, and here we present three of the first cases of hemorrhagic retinal artery macroaneurysms that resulted in BALAD.Methods: A retrospective review of three patients who presented for acute, painless, monocular vision loss was performed. Multimodal imaging including fundus photography and OCT are included in this analysis.Results: Three elderly female patients, all with a history of hypertension, presented with ruptured macroaneurysms involving the macula. All three patients had evidence of BALAD on OCT. Various management strategies were used.Conclusion: Hemorrhagic retinal arterial macroaneurysms can be associated with BALAD, observed best on OCT. This is most likely secondary to the rapid accumulation of intraretinal fluid during the hemorrhage, which leads to an avulsion at the inner segment myoid zone-a site of inherent structural weakness in the photoreceptors. Visual recovery may be improved in instances of hemorrhagic macroaneurysms associated with BALAD, similar to other disease entities where BALAD occurs, although further research is needed.

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“…Hypertension and older age lead to hyaline degeneration of the vascular walls, loss of autoregulatory tone and elastic recoil, and arterial dilatation [ 3 ]. RAM may undergo spontaneous involution in up to 75% of cases [ 4 ]. However, one-third of patients will develop vascular leakage and retinal oedema which require prompt treatment to prevent permanent central vision loss [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Objective Assessment of Retinal Artery Macroaneurysm With Optical Coherence Tomography Angiography

Lokman¹,

Bastion²,

Hamzah³

2022

Cureus

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Retinal artery macroaneurysm (RAM) is an acquired retinal arteriole dilatation with vision-threatening complications. Diagnosis of this condition can be made clinically, supported by multi-modal imaging modalities, commonly optical coherence tomography (OCT) and dye-based angiography studies which show the lesion itself and the complications to the adjacent retina. We report a case of an 83-year-old patient with renal impairment who had the diagnosis and monitoring of RAM done using optical coherence tomography angiography (OCT-A) as an alternative to conventional fluorescein angiography. This case highlighted the use of OCT-A using Cirrus 5000 with AngioPlex (Zeiss, Jena, Germany) as a useful diagnostic and monitoring tool for RAM with its features that enables objective quantification of the disease activity via vessel and perfusion density pre-and post-laser treatment.

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Clinical characteristics of retinal arterial macroaneurysms and prognosis of different interventions

Cited by 12 publications

References 35 publications

Retinal Arterial Macroaneurysm in a Patient With Lynch Syndrome

Retinal Arterial Macroaneurysm in a Patient With Lynch Syndrome

Ruptured Retinal Arterial Macroaneurysms Associated with Hemorrhagic Bacillary Layer Detachments

Objective Assessment of Retinal Artery Macroaneurysm With Optical Coherence Tomography Angiography

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