PMC5859917_01
A 70-year-old female presented with decreased vision in the right eye. (a) Fundus photography shows the retinal arterial macroaneurysm (RAM) along the infratemporal vascular arcade, with surrounding subretinal hemorrhage and fluid. (b) TOP: optical coherence tomography angiography (OCT-A) retina slab clearly delineates the RAM. BOTTOM: spectral domain optical coherence tomography (SD-OCT) shows submacular fluid. (c) TOP: OCT-A superficial slab reveals the RAM. Bottom: SD-OCT shows submacular fluid.
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fig1
Fundus examination revealed a lesion along the infratemporal vascular arcade, consistent with RAM, and surrounding subretinal hemorrhage and fluid tracking into the macula (Figure 1(a)). SD-OCT showed submacular fluid (Figures 1(b) and 1(c), bottom). The RAM was well delineated on the OCT-A retina slab (Figure 1(b), top) and superficial slab (Figure 1(c), top).
One month following presentation, following intravitreal bevacizumab #1. (a) TOP: optical coherence tomography angiography (OCT-A) retina slab demonstrates reduced signal due to artifact and decreased flow signal through the retinal arterial macroaneurysm (RAM). BOTTOM: spectral domain optical coherence tomography (SD-OCT) reveals reduced submacular fluid. (b) TOP: OCT-A superficial slab shows reduced signal due to artifact and decreased flow signal through the RAM. BOTTOM: SD-OCT reveals decreased submacular fluid.
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SD-OCT showed reduced submacular fluid (Figures 2(a) and 2(b), bottom). The OCT-A retina slab (Figure 2(a), top) and superficial slab (Figure 2(b), top) demonstrated diminished signal due to artifact but also reduced flow signal through the RAM.
Two months following presentation, following intravitreal bevacizumab #2. (a) Fundus photography shows apparent sclerosis of the retinal arterial macroaneurysm (RAM) with lipid exudate in the macula. (b) TOP: optical coherence tomography angiography (OCT-A) retina slab demonstrates reduced flow signal through the retinal arterial macroaneurysm (RAM). BOTTOM: spectral domain optical coherence tomography (SD-OCT) shows restoration of the foveal contour. (c) TOP: OCT-A superficial slab reveals reduced flow signal through the RAM. BOTTOM: SD-OCT shows decreased submacular fluid.
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fig3
Fundus examination showed apparent sclerosis of the RAM, with persistent lipid exudate in the macula (Figure 3(a)). SD-OCT showed further reduction of submacular fluid (Figures 3(b) and 3(c), bottom). The OCT-A retina slab (Figure 3(b), top) and superficial slab (Figure 3(c), bottom) demonstrated reduced signal flow through the RAM with persistent flow through the normal arteriole.
Four months following presentation. (a) Fundus photography demonstrates the sclerosed retinal arterial macroaneurysm (RAM). (b) TOP: optical coherence tomography angiography (OCT-A) retina slab reveals further reduced flow signal through the RAM. BOTTOM: spectral domain optical coherence tomography (SD-OCT) reveals resolution of the submacular fluid. (c) TOP: OCT-A superficial slab shows reduced flow signal through the RAM. BOTTOM: SD-OCT reveals improved macular contour.
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fig4
Fundus examination showed persistent sclerosis of the RAM, with reduced lipid exudate in the macula (Figure 4(a)). SD-OCT showed restoration of the macular contour (Figures 4(b) and 4(c), bottom). The OCT-A retina slab (Figure 4(b), top) and superficial slab (Figure 4(c), bottom) showed further reduced signal flow through 4 the RAM with persistent flow through the normal arteriole.