Retinal structural changes associated with retinal arterial macroaneurysm examined with optical coherence tomography.
OBJECTIVE
To study the retinal structural changes associated with a retinal arterial macroaneurysm and their association with visual prognosis.


METHODS
We studied retrospectively the medical records of 44 eyes of 44 patients with a retinal arterial macroaneurysm; all eyes showed hemorrhagic and/or exudative changes of the fovea with a visual disturbance. The retinal structural changes were examined by optical coherence tomography (OCT).


RESULTS
At the initial visit, 30 eyes (68%) showed severe hemorrhagic complications. In eyes with subretinal hemorrhage beneath the fovea, retinal structure was relatively preserved at the initial visit. At the final visit, however, foveal structure was often degenerated, especially in its outer aspect, with limited visual recovery. The 14 eyes (32%) with minimal hemorrhagic complications showed an extensive exudative change caused by the aneurysm. In 13 of these eyes, OCT examination revealed extensive retinal edema, predominantly in the outer retina. Retinal edema beneath the fovea caused a focal serous retinal detachment in 12 eyes. Eight eyes with extensive exudative change showed an accumulation of hard exudates in the macular area, and visual recovery of these eyes was often limited.


CONCLUSIONS
Subretinal hemorrhage or extensive exudative change from a retinal arterial macroaneurysm can cause destruction of the foveal outer photoreceptor layer, resulting in a poor visual outcome.
Tsujikawa
Akitaka
A
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Japan. tujikawa@kuhp.kyoto-u.ac.jp
Sakamoto
Atsushi
A
Ota
Masafumi
M
Oh
Hideyasu
H
Miyamoto
Kazuaki
K
Kita
Mihori
M
Yoshimura
Nagahisa
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D017542:Aneurysm, Ruptured / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D010211:Papilledema / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D020419:Photoreceptor Cells, Vertebrate / Q000473:pathology*; D011379:Prognosis; D012161:Retinal Artery / Q000473:pathology* / Q000601:surgery; D012166:Retinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy