Long-term, therapy-related visual outcome of 49 cases with retinal arterial macroaneurysm: a case series and literature review

Koinzer, Stefan; Heckmann, Jan; Tode, Jan; Roider, Johann

doi:10.1136/bjophthalmol-2014-305884

Cited by 33 publications

(25 citation statements)

References 33 publications

(53 reference statements)

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“…As the study was retrospective and nonrandomized, it is difficult to determine whether worse final VA in laser treated eyes was due to laser or to selection bias. A recent publication showed equivalent visual outcomes in laser treated eyes and those that were observed [ 17 ].…”

Section: Discussionmentioning

confidence: 89%

Long-Term Management of Complications of Retinal Artery Macroaneurysms with Intravitreal Aflibercept Injection

Kishore

2016

Case Rep Ophthalmol

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Purpose: To report the 1-year follow-up results of intravitreal aflibercept injection (IAI) for the management of complications of retinal artery macroaneurysms (RAM). Methods: A retrospective, noncomparative, interventional case series of 4 eyes of 4 patients (all female, aged 68–91 years, 3 treatment naive) treated with IAI 2 mg for complications of RAM [macular edema (ME) 2, submacular hemorrhage (SMH) 1, and vitreous hemorrhage (VH) 1] was conducted. Baseline parameters consisted of complete ocular examination, medical history, best-corrected Snellen VA, fundus photography, IVFA and SD OCT, unless precluded by VH (1). All patients completed ≥1 year follow-up. Results: Baseline VA was hand motions in the eye with SMH (31 mm² area and 1,478 μm thickness); 20/40 and 20/100 with ME (CST 390 and 337 μm, respectively), and 20/200 in the eye with VH. At 1 month, both patients with ME showed resolution of ME with CST <300 μm with improvement in VA which was maintained through 1 year. VH resolved in one eye at 1 month with no recurrence after 1 year. The eye with SMH developed macular scar and had counting fingers vision at 1 year. Thrombosis of RAM was noted in all eyes and hairpin-like remodeling of artery in one. No eye required repeat injection or laser. Conclusion: ME and VH from RAM were effectively treated with IAI. However, the eye with thick SMH had poor visual outcome despite thrombosis of RAM. Single IAI provided effective therapy for complications of RAM with excellent anatomical and visual results in each eye, except one with thick SMH, and merits further study.

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Section: Discussionmentioning

confidence: 89%

Long-Term Management of Complications of Retinal Artery Macroaneurysms with Intravitreal Aflibercept Injection

Kishore

2016

Case Rep Ophthalmol

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“…Laser for RAM has been reported using yttrium aluminum garnet (YAG), conventional photocoagulation (argon or krypton), and subthreshold treatment using infrared diode [ 5 ]. If the RAM causes vitreous hemorrhage, then pars plana vitrectomy techniques may be considered [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Angiography of Retinal Arterial Macroaneurysm before and after Treatment

Chang

Schwartz

Flynn

2018

Case Reports in Ophthalmological Medicine

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A case of retinal arterial macroaneurysm (RAM) is presented with multimodal imaging, including commercially available optical coherence tomography angiography (OCT-A). Following treatment with intravitreal bevacizumab, reduction of flow signal through the RAM is documented. OCT-A provides useful information for the diagnosis and management of at least some patients with RAM, without the need for traditional fluorescein angiography.

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“…Visual outcome for ruptured RAM is favorable [ 9 , 10 ]. Treatment options for ruptured RAM include observation, focal laser coagulation, and intravitreal bevacizumab for secondary macular edema [ 9 , 10 , 11 , 12 , 13 , 14 ]. Observation is sufficient in some uncomplicated cases, as aneurysmal hemorrhaging usually spontaneously undergoes sclerosis and occlusion as part of its natural course [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Ruptured Retinal Arterial Macroaneurysm Secondary to Toxoplasmic Kyrieleis Arteriolitis: A Case Report

Huang

Lee

Rivera

et al. 2017

Case Rep Ophthalmol

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Purpose: The aim of this report was to describe multimodal ocular imaging findings in a patient who presented with a ruptured retinal arterial macroaneurysm (RAM) associated with toxoplasmic Kyrieleis arteriolitis. Methods: We report the case of a 64-year-old man with a history of systemic hypertension and dense amblyopia of the left eye who presented with decreased vision and new floaters in the left eye. Color fundus photography, spectral-domain optical coherence tomography, fluorescein angiography, and indocyanine green angiography were used as diagnostic imaging tools. Results: No signs of hypertensive retinopathy were noted in the right eye. Multiple chorioretinal scars characteristic of previous toxoplasmosis were revealed in the left eye, with one covering most of the macula. Periarterial plaques or Kyrieleis arteriolitis were observed in retinal arteries surrounding the toxoplasmic retinal scars. Multiple RAMs were observed in these vessels, one of which was acutely ruptured. A perivenular plaque associated with a chronic branch retinal vein occlusion (BRVO) was noted along the same arcade at the arteriovenous crossing. Conclusion: RAM formation and BRVO can present as possible long-term complications of toxoplasmic Kyrieleis arteriolitis. This is the first reported case demonstrating an association between toxoplasmic Kyrieleis arteriolitis and RAM formation.

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Long-term, therapy-related visual outcome of 49 cases with retinal arterial macroaneurysm: a case series and literature review

Cited by 33 publications

References 33 publications

Long-Term Management of Complications of Retinal Artery Macroaneurysms with Intravitreal Aflibercept Injection

Long-Term Management of Complications of Retinal Artery Macroaneurysms with Intravitreal Aflibercept Injection

Optical Coherence Tomography Angiography of Retinal Arterial Macroaneurysm before and after Treatment

Ruptured Retinal Arterial Macroaneurysm Secondary to Toxoplasmic Kyrieleis Arteriolitis: A Case Report

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