PMC4396452_01
Fluorescein angiography and fundus photographs.. Notes: (A) Fluorescein angiogram demonstrating a superotemporal macroaneurysm with surrounding leakage and blockage by blood. (B) Fundus photograph of the superotemporal RAM with surrounding exudation involving the macula. Best-corrected visual acuity was 20/30. (C) After initial improvement in vision and macular edema with intravitreal bevacizumab, the patient was observed for a period of 3 months. The hemorrhage and edema worsened, and the visual acuity worsened to 20/60. Additional anti-VEGF was given, and the vision improved to 20/30. (D) After 19 months of anti-VEGF therapy, the edema worsened, and the vision again decreased to 20/60. The decision was made to undergo laser photocoagulation around the RAM. (E) After laser photocoagulation, the RAM is occluded and the exudates have mostly resolved.. Abbreviations: RAM, retinal artery macroaneurysm; VEGF, vascular endothelial growth factor.
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Dilated fundus examination and fluorescein angiography of the left eye revealed a superotemporal retinal arterial macroaneurysm, with surrounding circinate exudates involving the fovea (Figures 1 and 2).
Progression on OCT.. Notes: (A) Cirrus OCT of the exudates and edematous retinal thickening surrounding the superotemporal retinal artery macroaneurysm. (B) Initial OCT of the fovea demonstrating cystoid macular edema and a CFT of 312 mum. (C) OCT demonstrating recurrence of the macular edema after intravitreal bevacizumab. CFT was 349 mum. (D) Despite initial improvement in visual acuity and the retinal thickness improved, then worsened again after 14 months of bevacizumab. The CFT was 520 mum. (E) OCT of the macula after definitive laser therapy, with a reduction of retinal thickness to 241 mum.. Abbreviations: CFT, central foveal thickness; OCT, optical coherence tomography; ILM, Internal limiting membrane; RPE, retinal pigment epithelium; S, superior; I, inferior; N, nasal; T, temporal.
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Dilated fundus examination and fluorescein angiography of the left eye revealed a superotemporal retinal arterial macroaneurysm, with surrounding circinate exudates involving the fovea (Figures 1 and 2).