Retinal arterial macroaneurysm causing multilevel retinal hemorrhage

The use of bevacizumab in a multilevel retinal hemorrhage secondary to retinal macroaneurysm: a 39-month follow-up case report

“…As arterioles age, intimal collagen replaces smooth muscle fibers, and the arterial wall becomes less elastic. These vessels are thought to be more susceptible to dilation from elevated hydrostatic pressure 1,6. This phenomenon is more evident in hypertensive patients, who also experience elevated hydrostatic pressure, decreased autoregulation, and hyaline degeneration and are therefore especially at risk 1,6.…”

“…These vessels are thought to be more susceptible to dilation from elevated hydrostatic pressure 1,6. This phenomenon is more evident in hypertensive patients, who also experience elevated hydrostatic pressure, decreased autoregulation, and hyaline degeneration and are therefore especially at risk 1,6. Systemic hypertension has been implicated as a risk factor for exacerbation of several ocular ischemic disorders due to increased vascular permeability and intraocular neovascularisation, conditions that are primarily mediated by VEGF.…”

“…This may also play a role in the formation of a MA; however, the precise pathogenetic cause of focal arterial wall weakness is not fully understood. In general, it is agreed that a MA occurs at arteriovenous crossings where the vessels are in contact without an adventitial layer, resulting in an area with less structural support 1,6…”

Spectral Domain Optical Coherence Tomography in Juxtapapillary Macroaneurysm

“…MA formation is thought to be the consequence of ageing arteries and arterial wall weakness resulting in increased susceptibility to dilatation [8]. Systemic association with hypertension is found in 75 % of cases [7], MA may mimic various ocular conditions, which explains why diagnosis has to be confirmed by FA and ICGA [7]. ICGA is an important clue to the diagnosis when important preretinal bleeding or exsudation have occurred [7].…”

“…Systemic association with hypertension is found in 75 % of cases [7], MA may mimic various ocular conditions, which explains why diagnosis has to be confirmed by FA and ICGA [7]. ICGA is an important clue to the diagnosis when important preretinal bleeding or exsudation have occurred [7]. OCT has become an important tool for various retinal diseases since its introduction in the nineties.…”