Management of Retinal Macroaneurysms: A Case Series and Treatment Approaches
Year: 2026
Type: article
Study design: Case Report
Abstract: Retinal arterial macroaneurysms (RMAs) are uncommon vascular lesions that can lead to visual impairment through exudation or hemorrhage. We report a retrospective case series of four patients with symptomatic RMAs evaluated using multimodal imaging and managed with different therapeutic approaches. All patients presented with decreased visual acuity and a history of systemic hypertension. Initial best-corrected visual acuity (BCVA) ranged from 1/10 to 5/10. Multimodal imaging—including optical coherence tomography (OCT), fluorescein angiography (FA), and OCT angiography—enabled accurate characterization of lesion type (exudative versus hemorrhagic) and guided treatment decisions. Three patients with exudative macroaneurysms received intravitreal anti-VEGF therapy (bevacizumab), resulting in macular edema reduction and BCVA improvement by 1–3 lines. One patient with combined focal laser achieved additional lesion stabilization. One patient with multilayered macular hemorrhage underwent pars plana vitrectomy with internal limiting membrane peeling, leading to anatomical resolution but limited functional recovery (BCVA improved from 2/10 to 4/10). These findings highlight the importance of multimodal imaging in differentiating exudative and hemorrhagic RMAs and tailoring treatment strategies. Intravitreal anti-VEGF therapy appears effective as a first-line approach in most symptomatic cases, with adjunctive laser or surgical intervention reserved for selected presentations.
Institution: Mohammed V University
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W7153578676
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