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Review
. 2014 Jul-Sep;7(3):131-7.
doi: 10.1016/j.optom.2013.08.002. Epub 2013 Sep 26.

Ruptured retinal arterial macroaneurysm: diagnosis and management

Ashley M Speilburg  1 , Stephanie A Klemencic  2
Affiliations
Review

Ruptured retinal arterial macroaneurysm: diagnosis and management

Ashley M Speilburg et al. J Optom. 2014 Jul-Sep.

Abstract
in English, Spanish

Retinal arterial macroaneurysm is an acquired, focal dilation of a retinal artery, typically occurring within the first three bifurcations of the central retinal artery. The clinical presentation of a retinal arterial macroaneurysm is highly variable, making initial diagnosis difficult and differentials many. Identification of retinal arterial macroaneurysms is crucial to appropriately co-manage with the primary care physician for hypertension control. Prognosis is generally good and observation is often an adequate treatment. However, in cases of macular threat or involvement, some treatment options are available and referral to a retinal specialist is indicated.

El macroaneurisma de la arteria retiniana es una dilatación focal y adquirida de una arteria retiniana, que se produce normalmente en de las primeras tres bifurcaciones de la arteria central de la retina. La presentación clínica del macroaneurisma de la arteria retiniana es altamente variable, lo que dificulta el diagnóstico inicial dadas las muchas características diferenciales. La identificación de dichos macroaneurismas es esencial para poder coordinar con el facultativo de atención primaria el control de la hipertensión. El pronóstico es generalmente bueno, siendo a menudo la observación el tratamiento adecuado. Sin embargo, en casos de amenaza o afectación macular, las opciones de tratamiento son variables, recomendándose la derivación al especialista de la retina.

Keywords: Exudación, hipertensión; Exudation; Hemorragia retiniana; Hypertension; Macroaneurisma de la arteria retiniana; Pérdida súbita de visión; Retinal arterial macroaneurysm; Retinal hemorrhage; Sudden vision loss.

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Figures

Figure 1
Figure 1
Left fundus at presentation. A large preretinal hemorrhage obscures visualization of the macula. Areas of intraretinal and subretinal blood are also seen.
Figure 2
Figure 2
Fluorescein angiogram of the left eye shows blockage of fluorescein by the preretinal hemorrhage and no leakage is observed from the presumed location of the RAM.
Figure 3
Figure 3
Two weeks status-post pars plana vitrectomy, a resolving RAM is visible along the superior-temporal arcades surrounded by resolving sub-retinal blood.
Figure 4
Figure 4
Five months status-post pars plana vitrectomy, resolution of the RAM is nearly complete.
See this image and copyright information in PMC

References

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