Laser therapy versus observation for symptomatic retinal artery macroaneurysms

Meyer, Jacob C.; Ahmad, Baseer; Blinder, Kevin J.; Shah, Gaurav K.

doi:10.1007/s00417-014-2730-3

Cited by 22 publications

(18 citation statements)

References 18 publications

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“…Laser photocoagulation can be performed directly on the retinal macroaneurysm or indirectly by surrounding the macroaneurysm with laser points. There is no consensus as to whether direct or indirect treatment yields better results [ 3 ]. Intravitreal anti-vascular endothelial growth factor therapy appears promising as an alternative to laser treatment in cases of retinal macroaneurysms with macular exsudation [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography (OCT) angiography findings in retinal arterial macroaneurysms

Alnawaiseh¹,

Schubert²,

Nelis³

et al. 2016

BMC Ophthalmol

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BackgroundOptical coherence tomography angiography is a novel imaging technique that allows dyeless in vivo visualization of the retinal and choroidal vasculature. The purpose of this study was to describe optical coherence tomography (OCT) angiography findings in patients with retinal arterial macroaneurysms (RAMs).MethodsThree eyes of three patients with RAMs were retrospectively included. Fundus photography, OCT, fluorescein angiography (FA), and OCT angiography were performed. The entire imaging data was analyzed in detail.ResultsOCT angiography could detect the RAMs noninvasively without dye injection. By simultaneously observing the OCT scans, it was possible to determine the depth of the RAMs in the retina, to detect the exact localization in relation to the main vessel, and to determine the level of blood flow in the RAMs.ConclusionsOCT angiography can clearly visualize RAMs without use of a dye. It also allows layer-specific observation of blood flow in each layer of the RAM. OCT angiography provides additional dynamic information on RAMs, which is not obtained with FA and facilitates a better understanding of its morphology and activity. This information in combination with ICG and fluorescein angiography can help to optimize direct laser treatment.

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Section: Introductionmentioning

confidence: 99%

Optical coherence tomography (OCT) angiography findings in retinal arterial macroaneurysms

Alnawaiseh¹,

Schubert²,

Nelis³

et al. 2016

BMC Ophthalmol

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“…Exudative retinal macroaneurysms impair vision when the fovea is committed by macular edema, serous retinal detachment or hard exudates [ 3 ]. These situations are usually considered indications to treat retinal macroaneurysms instead of observing and waiting for them to regress spontaneously.…”

Section: Discussionmentioning

confidence: 99%

“…There is no established treatment protocol [ 1 , 2 ]. In exudative macroaneurysms with foveal commitment, the most popular treatment modality is laser photocoagulation directed towards the lesion or the surrounding tissue [ 3 ]. Treatment with intravitreal vascular endothelium growth factor (VEGF) inhibitors (bevacizumab [ 4 , 5 , 6 , 7 , 8 , 9 ] and ranibizumab [ 8 , 10 , 11 ]) has had a few encouraging outcomes.…”

Section: Introductionmentioning

confidence: 99%

Foveal Exudative Macroaneurysm Treated with Intravitreal Ranibizumab

Menezes

Carvalho

Teixeira

et al. 2015

Case Rep Ophthalmol

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Purpose: We report a case of a foveal macroaneurysm with long-standing macular edema in a rare location, successfully treated with intravitreal ranibizumab. Methods: We report the case of a 52-year-old man with left eye long-term visual loss due to macular edema caused by a retinal macroaneurysm, localized about 400 μm from the center of the fovea, and its response to 6 monthly ranibizumab intravitreal injections. His best-corrected visual acuity and morphological data evaluated by optical coherence tomography and fluorescein angiography are presented. Results: His best-corrected visual acuity improved from 1/10 to 3/10 after the 3rd injection, and from 1/10 to 4/10 after the 6th one. The central retinal thickness was evaluated by optical coherence tomography and improved from 310 to 233 μm, with the resolution of both the associated serous detachments and the cystoid macular edema; an almost complete reabsorption of the hard exudates at the end of the treatment was also observed. The macroaneurysm lumen almost obliterated after the 3rd injection and completely collapsed at the end of treatment. Conclusions: Intravitreal ranibizumab may be effective in the treatment of long-standing macular edema associated with foveal macroaneurysms. To the best of our knowledge, this is the first report of a retinal macroaneurysm located so close to the foveal avascular zone.

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“…The vision in both groups improved, but the laser group experienced a greater gain. 7 Approximately 16%–27% of RAMs occlude with lasers, but there is a risk of vascular occlusion, early increase in exudates from selective reabsorption of fluid, arteriovenous shunts, macular pucker, and scotomas. 7 , 8 Other treatment options for RAMs include yellow dye laser and indocyanine green dye-enhanced photocoagulation.…”

Section: Discussionmentioning

confidence: 99%

Serial bevacizumab injections and laser photocoagulation for macular edema associated with a retinal artery macroaneurysm

Leung

Reddy

Vedula

et al. 2015

OPTH

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An 84-year-old female with a history of hypertension and dyslipidemia was referred for a retinal artery macroaneurysm with exudation that had extended into the macula. She underwent a total of six injections of bevacizumab, with some improvement in visual acuity and retinal thickness. Due to persistent macular edema, focal laser photocoagulation was performed around the macroaneurysm. The vision remained at 20/30 during 20 months of follow up. Although anti-vascular endothelial growth factor therapy may improve vision and decrease retinal thickness in retinal artery macroaneurysm, recalcitrant cases may be treated with laser photocoagulation to seal the leaking vessel.

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Laser therapy versus observation for symptomatic retinal artery macroaneurysms

Abstract: Treatment with direct laser photocoagulation was associated in this study with greater improvement in visual acuity and may decrease the risk of severe visual loss especially in primarily hemorrhagic RAM lesions. Compared to observation alone.

Cited by 22 publications

References 18 publications

Optical coherence tomography (OCT) angiography findings in retinal arterial macroaneurysms

Optical coherence tomography (OCT) angiography findings in retinal arterial macroaneurysms

Foveal Exudative Macroaneurysm Treated with Intravitreal Ranibizumab

Serial bevacizumab injections and laser photocoagulation for macular edema associated with a retinal artery macroaneurysm

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