Retinal artery macroaneurysms: Clinical and fluorescein angiographic features in 34 patients

Abstract

Aim: To describe the clinical and fluorescein angiographic features of patients with macroaneurysms (MAs) attending an ophthalmology department over 8 years. Methods: All the patients between 1997 and 2004 with a diagnosis of retinal artery MA were identified from hospital records. Photographs and fluorescein angiograms were examined, and the MAs classified according to their clinical (haemorrhagic or exudative) features, and angiographic (saccular or fusiform) features. Baseline data of the patients were taken including visual acuity and associated ocular and medical conditions. Results: A total of 38 MAs were identified in 34 patients. The age at presentation ranged from 36 to 93 years, with a mean of 73.7 years. Of them, 24/34 (70%) were female patients, and 10/34 (30%) were male patients. There was a history of hypertension in 9/14 patients (64.3%). Of 38 MAs, 32 were identifiable as either saccular or fusiform. Of these, 22/32 (68.75%) were saccular, the rest fusiform. In all, 72.7% of the saccular MAs showed haemorrhage as the predominant feature. Of the 10 fusiform MAs, 90% showed haemorrhage as the predominant feature. Conclusion: Retinal artery macroaneurysm is a rare condition that may mimic a variety of other conditions. Most MAs do not require treatment. We suggest guidelines for diagnosis and propose a treatment algorithm for this condition.