Early treatment with Nd-YAG laser for a premacular hemorrhage secondary to a retinal macroaneurysm

Abid, Fatma Ben; Sellami, Dorra; Yahia, Salim Ben; Gargouri, S.; Ammous, Donia; Khairallah, Moncef; Feki, Jamel

doi:10.1016/j.jfo.2016.07.016

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…Although the natural course of the RAM can be self-regressive [ 17 ] there are several counter-arguments which indicate a demand for the interventional approach. Firstly, non-resolving cases may be complicated by a rupture of the RAM wall and significant preretinal hemorrhage [ 18 ] or by BRVO [ 19 , 20 ], both of which result in significant visual deterioration and require vitrectomy [ 4 ]. Secondly, it is worth noting the absence of substantial visual improvement in a significant proportion of patients in our study even after complete resolution of retinal exudation.…”

Section: Discussionmentioning

confidence: 99%

Direct navigated laser photocoagulation as primary treatment for retinal arterial macroaneurysms

et al. 2018

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ObjectivesTo compare the efficacy and safety of conventional and navigated laser photocoagulation as the primary treatment option for retinal arteriolar macroaneurysm (RAM).MethodsEleven (9 male and 2 females, mean age 65.1 ± 12.1 years) and 17 (13 male and 4 females, mean age 66.2 ± 8.9 years) patients were included in conventional laser photocoagulation (CLP) and navigated laser photocoagulation (NLP) groups, respectively. The primary outcome measures were LogMAR best-corrected visual acuity (BCVA) and central retinal thickness at the end of the follow-up. The secondary outcome measure was total laser energy applied during the procedure.ResultsAt the end of the mean follow-up of 11.4 ± 4.0 months, baseline LogMAR BCVA increased significantly from 0.65 ± 0.14 to 0.26 ± 0.12 (p < 0.001) in CLP group and from 0.57 ± 0.33 to 0.29 ± 0.34 (p < 0.001) in NLP group. Central retinal thickness decreased significantly from 514.5 ± 53.2 µm to 295.3 ± 11.3 µm (p < 0.001) and from 494.0 ± 111.2 µm to 285.8 ± 51.4 µm (p < 0.001) in CLP and NLP group, respectively. Total laser energy and number of laser burns applied per procedure in NLP group was statistically significantly lower than in CLP group (0.28 ± 0.13 J vs 0.59 ± 0.06 J, p < 0.001 and 28.5 ± 14.2 burns vs 48.9 ± 5.1 burns, respectively, p < 0.001). No adverse events related to laser treatment was noted in study groups during the follow-up.ConclusionThis study demonstrated superiority of navigated laser photocoagulation compared to conventional laser photocoagulation in primary treatment of RAM which results from similar efficacy and safety of both techniques with lower mean total laser energy and number of laser burns required for navigated laser photocoagulation.

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Section: Discussionmentioning

confidence: 99%

Direct navigated laser photocoagulation as primary treatment for retinal arterial macroaneurysms

et al. 2018

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“…In contrast to retinal arterial macroaneurysms, retinal venous macroaneurysms are quite rare and have almost exclusively been reported to develop after branch retinal vein occlusions [ 3 , 7 ]. Very few cases of isolated retinal venous macroaneurysm without venous occlusion have been described in the literature [ 4 – 6 , 8 ]. Since isolated retinal venous macroaneurysm is so rare, the course and complications of these lesions are not well-known.…”

Section: Discussionmentioning

confidence: 99%

“…Since isolated retinal venous macroaneurysm is so rare, the course and complications of these lesions are not well-known. After a thorough Medline search, we could find few case reports, in which acute macular hemorrhage due to isolated retinal venous macroaneurysm was presented [ 5 , 6 ]. In these reports, premacular hemorrhages were successfully treated with either Nd:YAG or argon green laser.…”

Section: Discussionmentioning

confidence: 99%

“…Unlike retinal arterial macroaneurysms, retinal venous macroaneurysms are extremely rare and can be either isolated or associated with venous occlusive disease [ 3 , 4 ]. After a thorough search of literature, very few cases with premacular hemorrhage due to retinal venous macroaneurysm have been reported [ 5 , 6 ]. In this case report, we describe a patient who had a recent multilevel premacular hemorrhage caused by an isolated retinal venous macroaneurysm and was treated with a pulsed Nd:YAG laser to drain the entrapped blood into the vitreous.…”

Section: Introductionmentioning

confidence: 99%

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Nd:YAG Laser Photodisruption for Multilevel Premacular Hemorrhage due to Isolated Retinal Venous Macroaneurysm

Sönmez

Özcan

2017

Case Reports in Ophthalmological Medicine

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A 55-year-old man presented with sudden deterioration of vision in the right eye. His visual acuity was reduced to hand motion because of a large multilevel premacular hemorrhage. Nd:YAG laser was performed to drain the entrapped hemorrhage under the internal limiting membrane (ILM) and posterior hyaloid face in the macula into the vitreous. Immediately after laser treatment, streaming of red blood cells into the vitreous gel through the perforation site was observed. At the first-month follow-up, BCVA improved to 20/25 and ILM wrinkling was observed at the macula where the preretinal hemorrhage cleared. Fluorescein angiography revealed an isolated retinal venous macroaneurysm located on the macular branch of the superotemporal vein at the bifurcation site. In contrast to retinal arterial macroaneurysms, retinal venous macroaneurysms are quite rare. To the best of our knowledge, this is the first case reported with multilevel premacular hemorrhage caused by an isolated retinal venous macroaneurysm.

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Preretinal hemorrhage preventing subretinal involvement in multilayer macular hemorrhages: coincidence or plausible relationship?

Nascimento

Carbajo

Mendonça³

et al. 2021

Int J Retin Vitr

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Background To report four cases with interesting anatomical presentations of multilayer macular hemorrhages with preretinal hemorrhage possibly preventing subretinal involvement of the macular area. Cases presentation Observational study of four patients presenting with macular hemorrhages. Results Four patients with multilayer macular hemorrhage due to different causes, presented with a halo-shaped submacular hemorrhage coincident with the preretinal hemorrhage borders. After resolution, in all cases, the macular area underneath the preretinal hemorrhage was found to be spared. Conclusion We hypothesized that an extensive preretinal hemorrhage can exert a mechanical force pushing the subretinal hemorrhage towards the periphery, consequently protecting the macular area.

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Early treatment with Nd-YAG laser for a premacular hemorrhage secondary to a retinal macroaneurysm

Cited by 3 publications

References 5 publications

Direct navigated laser photocoagulation as primary treatment for retinal arterial macroaneurysms

Direct navigated laser photocoagulation as primary treatment for retinal arterial macroaneurysms

Nd:YAG Laser Photodisruption for Multilevel Premacular Hemorrhage due to Isolated Retinal Venous Macroaneurysm

Preretinal hemorrhage preventing subretinal involvement in multilayer macular hemorrhages: coincidence or plausible relationship?

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