title: [Clinical Research of Factors Influencing Visual Outcomes in Patients with Hemorrhagic Retinal Arterial Macroaneurysms].
abstract: OBJECTIVE
  To identify factors influencing visual outcomes in patients with hemorrhagic retinal arterial macroaneurysms (MA).
  
  
  METHODS
  We retrospectively reviewed the charts of 13 eyes of 13 patients with hemorrhagic MAs. We evaluated factors. including age, blood pressure, ocular perfusion pressure, optic disc-MA distance, MA-fovea distance, the area of the hemorrhage, the time between onset and treatment, initial visual acuity, and the presence of subfoveal hemorrhage. Additionally, we measured the retinal cross-sectional area of the fovea with optical coherence tomography (OCT).
  
  
  RESULTS
  There were significant differences in MA-fovea distance, area of the subretinal hemorrhage, and visual outcome in eyes with or without subfoveal hemorrhage (p < 0.05). Spearman's correlation analysis showed a significant negative correlation between visual outcome (logMAR) and disc-MA distance (rS = -0.61, p < 0.05), as well as MA-fovea distance (rS = -0.79, p < 0.01). A multivariate analysis showed an independent negative correlation between visual outcome and MA-fovea distance (Stdβ = -0.66, t = 3.21, p < 0.01). In addition, there was a significant positive correlation between MA-fovea distance and the affected-/healthy-eye ratio of outer-retinal-layer cross-sectional area in the fovea (rS = 0.64, p < 0.05). The cutoff value of MA-fovea distance for subfoveal hemorrhage was 3000 microns, with a sensitivity of 100, specificity of 77.8, positive predictive value of 66.7 and a negative predictive value of 100.
  
  
  CONCLUSIONS
  When hemorrhagic MAs are located closer to the fovea, the outer retinal layer is more severely affected and visual outcomes are poorer. Subfoveal hemorrhage should be considered even when it is not apparent, especially when the hemorrhagic MA is located within 3000 microns of the fovea.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Asano
authors.forename: Takehiro
authors.initials: T
authors.lastname: Hariya
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kanazawa
authors.forename: Toru
authors.initials: T
authors.lastname: Nakazawa
authors.forename: Hajime
authors.initials: H
authors.lastname: Sato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D012161:Retinal Artery; D012166:Retinal Hemorrhage / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies; D014792:Visual Acuity