Two suspected sequential retinal arterial macroaneurysms in a single eye with secondary nonvascular cystoid macular edema: 5-year follow-up: a case report
Year: 2026
Type: article
Study design: Case Report
Abstract: Background: Retinal arterial macroaneurysm (RAM) is an acquired vascular disorder. The long-term natural history of multiple RAMs in a single eye complicated by nonvascular cystoid maculopathy (NVCM) is rarely documented. Case presentation: A 65-year-old hypertensive woman presented with acute vision loss in her left eye secondary to severe vitreous hemorrhage. She underwent pars plana vitrectomy with intravitreal recombinant tissue plasminogen activator thrombolysis and silicone oil tamponade. Postoperative multimodal imaging supported the diagnosis of two suspected sequential RAMs confined to the left eye. Over a 5-year follow-up, the two lesions exhibited divergent outcomes: one developed fibrosis and persistent NVCM associated with severe initial hemorrhage and inadequate blood pressure control, whereas the other regressed completely following rigorous systemic hypertension management. Conclusions: Multiple RAMs within the same eye can follow distinctly divergent natural courses. In this single case, early blood pressure control appeared to be an important contributing factor to the divergent lesion outcomes, although the contribution of spontaneous regression and other confounding factors cannot be excluded. Multimodal imaging is indispensable for differentiating NVCM from vasogenic macular edema, guiding individualized conservative management, and preventing unnecessary interventions.
Source: Frontiers in Medicine
Authors: Kaiyao Chi, Daoxi Lei, Tong Guo, Xiaoding Shui, Huili Li
Institution: Chongqing College of Traditional Chinese Medicine
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Award: G1334741775
OpenAlex ID: W7222495083
