Bilateral multiple retinal artery macroaneurysms with coexistent diabetic retinopathy

Abstract

To discuss the clinical profile of retinal artery macroaneurysms (RAMs), its presentation, rarity, complexity in diagnosis and management modalities. RAMs are seen commonly in elderly females who have associated systemic hypertension. Most of these aneurysms undergo spontaneous involution due to fibrosis while others may result in vascular leakage with macular oedema and haemorrhage into various layers of retina. Long-standing exudation may result in the development of cystoid macular oedema (CME), macular hole, macular exudate, retinal gliosis, and atrophy. Since the arterioles are high-flow vessels, it ruptures under high pressure resulting in haemorrhages at various levels – vitreal, preretinal, intraretinal, and subretinal. Multiple RAMs maybe hereditary, inherited in an autosomal recessive pattern presenting with recurrent vitreous haemorrhage. Treatment is to ensure rapid resolution of haemorrhage and exudation thereby facilitating early visual recovery and avoiding permanent visual loss. Referral to a physician is essential for the management of hypertension and associated systemic illnesses. Here we describe a case of multiple bilateral macroaneurysms with coexistent diabetic retinopathy.

Keywords

• cystoid macular oedema
• hypertension
• macular exudate
• retinal artery macro aneurysms
• retinal haemorrhage