Retinal Arterial Macroaneurysm

Retinal Arterial Macroaneurysm: A Brief Review

“…The mean age of patients with a RAM ranges from 66 to 74 years 2,3 ; 70% of cases occur in women and 90% of cases are unilateral. [1][2][3]7 The clinical presentation of RAMs is variable, and this can pose a diagnostic challenge.…”

“…The mean age of patients with a RAM ranges from 66 to 74 years 2,3 ; 70% of cases occur in women and 90% of cases are unilateral. [1][2][3]7 The clinical presentation of RAMs is variable, and this can pose a diagnostic challenge. While patients with RAMs may be asymptomatic and the lesions found on routine examination, up to 75% of RAMs are misdiagnosed upon first presentation, 2,6 often due to a presumption that an associated macular hemorrhage arises from a choroidal neovascular membranes or a retinal vein occlusion.…”

“…1,2,4 Retinal arterial macroaneurysms are usually found at arteriovenous crossings within the first three bifurcations of the central retinal artery, typically at arteriovenous crossings or the bifurcation itself (Figure 2). [1][2][3]8,9 At crossing sites and bifurcations, there is a lack of the adventitial layer which reduces structural support leaving them prone to aneurysm formation. 2,4,6 They can be classified as either fusiform (cuffed) or saccular (blowout) through angiography.…”

“…1,2,4,7 The FA can also show changes (i.e., dilation or telangiectasia) in associated capillaries near the RAM. 2,3 Indocyanine green angiography (ICG) can be helpful when retinal hemorrhage directly blocks visualization of a suspected RAM. 1,2,6 On FA, the absorption and emission peaks of the fluorescein dye are below the infrared spectrum, making visualization through hemorrhages difficult.…”

“…1,2 Retinal arterial macroaneurysms are associated with cardiovascular disease, most commonly systemic hypertension. [1][2][3][4] The presentation of RAMs is variable, which may make the diagnosis challenging. Herein, we review the clinical characteristics and management of patients with RAMs.…”