Purpose: To investigate morphologic characteristics of retinal arterial macroaneurysm (RAM) and its regression pattern using spectral-domain optical coherence tomography.
Methods: This observational case series included six eyes of six patients with RAM. All patients had undergone repeated comprehensive ophthalmologic examination, including measurement of best-corrected visual acuity, slit-lamp biomicroscopy, indirect fundus examination, fundus photography, fluorescein angiography, and spectral-domain optical coherence tomography (Spectralis OCT). Morphologic findings of RAM on spectral-domain optical coherence tomography and changes after treatment were investigated.
Results: On initial diagnosis, eyes with RAMs showed a round hyperreflective wall with a hyporeflective lumen on spectral-domain optical coherence tomography. Five of six patients underwent direct laser photocoagulation to the RAM. One hour after treatment, the lumen of the RAM showed a homogeneous high reflectance, indicating occlusion with thrombus. One or 2 months after treatment, spectral-domain optical coherence tomography demonstrated almost entirely obliterated RAMs and decreased perianeurysmal retinal edema. One patient showed spontaneous rupture and involution of RAM. Superficial location of RAM was associated with hemorrhagic complications.
Conclusion: Spectral-domain optical coherence tomography can show morphologic characteristics of RAM and structural changes after treatment. These new findings can be valuable not only in clinical diagnosis but also in predicting the treatment response of RAM.