Macroaneurysms of retinal arteries

Macroaneurysms of the retinal arteries are represented by local expansion of retinal arterioles, often 1, 2 and 3 orders. The most predisposed to them are elderly women with arterial hypertension; in 90% of cases the process is one-sided.

[1], [2], [3]

Symptoms of Macroaneurysm of the Retinal Arteries

Manifestations of macro-arthritis of the retinal arteries can be reduced to one of the following:

• Accidental detection of asymptomatic disorders
• A hidden decrease in the central visual acuity due to edema of the macula and the formation of solid exudate.
• Sudden loss of vision with a vitreous hemorrhage is rare.

Ocular fundus

• Saciform or fusiform expansions of arterioles often appear in the area of bifurcations or arteriovenous crossings along temporal vascular arcades. Aneurysms can increase, exceeding the diameter of the artery several times.
• Concomitant hemorrhage of the retina is observed in 50% of cases.
• Multiple microaneurysms can be observed in the course of both the same and different arterioles.

Foveal angiography depends on the nature of the disorders and accompanying hemorrhages. Typical is the uniform filling of macro-aneurysms with late sweating. Incomplete filling is due to partial or complete thrombotic obliteration of the lumen of the vessel.

The course of macronutrient artery retina

• Spontaneous involution with subsequent thrombosis and fibrosis is observed most often. This is preceded by the development of sweating or hemorrhage.
• A rupture with a hemorrhage may be subretinal, intretinal, preretinal, or vitreal. In such cases, the changes to be made may not be detected during the examination.
• Chronic sweating due to retinal edema with accumulation of solid exudate around the fovea is frequent and can cause a steady decrease in central vision.

Differential diagnosis of arterial macroinergic arthritis

Solid exudates of the posterior segment

• Nonproliferative diabetic retinopathy.
• Exudative form of age-related macular degeneration.
• Long-standing occlusion of the branch of the central vein of the retina.
• Telangiectasia of the retina.
• Small hemangiomas of the retinal capillaries.
• Radiation retinopathy.

Deep retinal or subretinal hemorrhages of the posterior segment

• Choroidal neovascularization.
• Retinopathy of Valsalva.
• Idiopathic polypoid choroidal vasculopathy.
• Dull eye trauma.
• Choroidal melanoma.

Terson syndrome with subarachnoid hemorrhage.

Treatment of macronutrient artery retina

1. Observation to identify early spontaneous involution is indicated with good visual acuity without changes in the macula, as well as in the presence of minor retinal hemorrhages in the absence of pronounced edema or exudation.
2. Argon laser coagulation is used in case of edema or deposits of solid exudate with the threat of fovea involvement, especially if vision impairment is noted. Coagulants are applied to focal changes and / or the surrounding zone. Dilution of edema and hard exudate occurs within several months.
3. YAG-laser hyaloidotomy can be shown with extensive non-absorbable preretinal hemorrhages covering the macula, in order to cause blood dispersion in the vitreal cavity where absorption occurs more quickly.