Vision loss from ruptured retinal artery macroaneurysm
How to cite this article: AU SCL, KO CKL. Vision loss from ruptured retinal artery macroaneurysm. Natl Med J India 34:2021;187.
A 67-year-old woman with HT had sudden loss of vision in the right eye from multilayered retinal haemorrhages (MLRH; Fig. 1), and fundus fluorescein angiography diagnosed partially ruptured RAM (Fig. 2) with hourglass configuration spillage of blood to pre-retinal and subretinal spaces (Figs 3 and 4). Optical coherence tomography over the RAM (Fig. 4, green arrow) outlined its cross-sectional oval shape located within the inner retinal layers (Fig. 4, black arrow).
Retinal artery macroaneurysm (RAM) occurs in patients with HT, especially women.1 The raised intravascular hydrostatic pressure from HT causes an increase in transmural pressure and wall tension. With ageing, smooth muscle fibres of the vessel wall are replaced by collagen, increasing its susceptibility to arterial dilatation, similar to the pathogenesis of intracranial aneurysms.1
Local treatment for RAM is usually not necessary given its natural course of self-thrombosis and self-resorption of blood. Being a modifiable risk factor for different end-organ complications, its control is essential to prevent both systemic and ocular complications.
Conflicts of interest