TACTICS OF TREATMENT FOR PATIENTS WITH RETINAL ARTERIAL MACRO-ANEURYSM

Abstract

Purpose. To present clinical cases of retinal arterial macroaneurysms with definition of features of clinical course and tactics of its treatment.Material and methods. The medical records of 12 patients which were observed and operated on retinal arterial macroaneurysms at our clinic between 2012 and 2013 were analyzed. All patients underwent a complete ophthalmic examination, including optical coherence tomography of retina and fluorescein angiography. According to clinical course, patients were divided into four groups: asymptomatic form – 3, hemorrhagic form – 2 and exudative form of macro-aneurysm – 6, as well as 1 ruptured macro-aneurysm was defined as a separate group. Patients were examined in dynamic follow-up every second day and 3, 6, 9 months after the surgery.Results. Negative dynamics was not observed in 2 patients in the Group 1, one patient required laser coagulation of macroaneurysm, due to an increased edema of the macular area. In the second group the patients underwent a combined surgery of macro-aneurysm laser coagulation and hyaloid puncture. Postoperative complications were not found, visual acuity was high. The combined laser coagulation was performed in patients with the exudative form of macro-aneurysm course and, if necessary, macular barrage. The positive dynamics was noted in 5 cases. Intravitreal Lucentis was injected to the patient of the group 4 as a first step, and barrage of macular area was made as the second step. In the postoperative period a complete resorption of hard exudates and an improvement in visual acuity were noted.Conclusion. The choice of treatment method of retinal arterial macro-aneurysm depends on the form of the course, localization of macro-aneurysms, complications and their duration.

Keywords

• retinal arterial macro-aneurysm
• laser coagulation of macro-aneurysm
• hyaloid puncture