Title

EFFICACY OF LASER PHOTOCOAGULATION IN RETINAL ARTERIAL MACROANEURYSM

Introduction

Report the efficacy of Photocoagulation as an isolated treatment in Retinal Arterial Macroaneurysm

Methods

Analysis of a clinical case occurred at the Santa Beatriz Ophthalmological Hospital in Niterói (RJ). A 46-year-old female, hypertensive and dyslipidemic patient with a left paracentral scotoma and rapid evolution to low visual acuity. OD: 20/20 and OE < 20/400. Fundoscopy shows intra and preretinal hemorrhage and retinal exudation in macula. After 2 weeks there was regression of preretinal hemorrhage and it was possible to visualize macroaneurysm. A focal photocoagulation performed (spot 200 micras; power 0.200 and exposure of 0.150) and follow-up.

Results

After 2 months of follow-up, intraretinal edema was absorbed and a better organization of retinal layers with significant improvement in visual acuity in OE (20/60).

Discussion

Macroaneurysm is a dilation of the rounded or fusiform retinal artery, usually in the first three arterial bifurcations of the posterior pole and that can cause retinal hemorrhages. Most of the time it is unilateral and isolated. It affects more female and the elderly. Systemic arterial hypertension, dyslipidemia and cardiovascular diseases are well established in the etiology of the disease. The most common symptom is low visual acuity, which may be insidious due to macular edema caused by fluid extravasation, or sudden, due to hemorrhage, which is less common. Angiofluoresceinography and OCT are useful for diagnosis, localization and individualized therapeutic proposal. Treatment involves clinical observation, laser photocoagulation, intravitreo injection of anti-VEGF and posterior vitrectomy. The choice of specific treatment depends on the type of injury and its location. Despite extensive intraretinal exudation, the isolated treatment with photocoagulation proved to be effective in resorption of edema and reorganization of retinal layers, and no adjuvant treatment with chemotherapy is required in this case.

Keywords

Photocoagulation ; Retinal Arterial Macroaneurysm ; Angiofluoresceinography

Area

CLINICAL CASE

Authors

THIAGO SIQUEIRA ROCHA, RAPHAEL de ALMEIDA PENTAGNA, ARMANDO MAGALHAES NETO, TULIO SANTOS SIQUEIRA PECANHA