Outcomes of combined treatments in patients with retinal arterial macroaneurysm

Abstract

Purpose: To evaluate the outcome of the combined approach between intravitreal ranibizumab (IVR) and focal laser photocoagulation (FLP) in the treatment of symptomatic retinal arterial macroaneurysm (RAM). Methods: A total of 10 patients were included in this clinical case series report. They were diagnosed with symptomatic RAM (one eye in each) and assessed by a comprehensive ophthalmologic examination, including fluorescein angiography (FA), optical coherence tomography angiography (OCT-A), and indocyanine green angiography (ICGA). All patients were treated with an IVR followed by an FLP 2 weeks later. If necessary, a second IVR was given 1 month after the first one (or 2 weeks after the first FLP), which was followed by a second FLP treatment 2 weeks later in the needed cases. All cases were followed up for 6 months after the last treatment. Results: Both the retina hemorrhage and edema were resolved by the treatment. No ocular and/or systemic side effects were evident, and no recrudescence of RAM was seen within the 6 months of follow-up. Conclusion: The combined treatment of IVRs and FLPs was successful in the management of symptomatic RAM.

Retinal laser photocoagulation and intravitreal injection of anti-VEGF for hemorrhagic retinal arterial microaneurysm

“…A study reported that combined treatment of laser and anti-VEGF could improve VA of symptomatic RAM [22] . However, in our study, patients in the combination group did not receive both laser and anti-VEGF treatments at the same time or within a short period; instead, the other treatment was added when the effect of the initial monotherapy failed to meet expectations.…”

Impacts of angiotensin II on retinal artery changes in apolipoprotein E deficient mice

“…RAM is usually asymptomatic and resolves spontaneously in most cases. However, when hemorrhage and/or exudation affect the macula, severe vision loss occurs despite aggressive treatments including photocoagulation, vitrectomy, or antivascular endothelial growth factor intravitreal injections [3][4][5] . The main pathophysiology of RAM involves weakness of the vascular wall owing to aging and arteriosclerosis, which makes it more susceptible to the increased hydrostatic pressure seen in hypertension, leading to the dilatation of a major retinal arteriole [6][7][8] .…”