Retinal arterial macroaneurysms: Risk factors of poor visual outcome

Chang Sue Yang, Der Chong Tsai, Fenq Lih Lee, Wen-Ming Hsu

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: To evaluate the long-term natural course and to identify the risk factors of a poor visual outcome in patients with retinal arterial macroaneurysms (MA). Methods: In this observational case series, we retrospectively evaluated the consecutive patients with MA at our institution over a 17-year period. The visual outcomes of the different types of MA (presented as predominantly hemorrhagic or exudative) were compared. Results: A total of 31 patients with 46 confirmed MA were identified. The ocular manifestations of MA included retinal hemorrhage (96.7%), retinal exudate (61.3%), macular involvement (77.4%) and vitreous hemorrhage (12.9%). Among the 10 cases of hemorrhagic-type MA, visual acuity improved by 2 or more lines in 9 (90%) and decreased in 1 patient (10%). In the 15 cases of exudative-type MA, 4 improved (26.7%), 8 remained stationary (53.3%) and 3 had decreased visual acuity (20.0%). The average vision change in the minimum angle of resolution improved by 0.59 log units in hemorrhagic MA and decreased by 0.07 log units in exudative MA (p < 0.01). With respect to change of vision, the eyes with hemorrhagic-type MA showed greater improvement than those with the exudative type, but the final visual outcome was not different in the 2 groups. Foveal exudate was a statistically significant risk factor for final vision equal to or worse than 6/30 (odds ratio = 6.93, p < 0.05). Conclusions: Different types of MA may have different clinical presentations. In the majority of MA, there is gradual and spontaneous involution. However, poor visual outcome may occur secondary to foveal exudates and subfoveal hemorrhage.

Original languageEnglish
Pages (from-to)366-372
Number of pages7
JournalOphthalmologica
Volume219
Issue number6
DOIs
Publication statusPublished - Nov 1 2005
Externally publishedYes

Fingerprint

Exudates and Transudates
Visual Acuity
Eye Manifestations
Retinal Hemorrhage
Vitreous Hemorrhage
Odds Ratio
Hemorrhage

Keywords

  • Fluorescein angiography
  • Foveal exudate
  • Hypertension
  • Retinal arterial macroaneurysms

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

Cite this

Retinal arterial macroaneurysms : Risk factors of poor visual outcome. / Yang, Chang Sue; Tsai, Der Chong; Lee, Fenq Lih; Hsu, Wen-Ming.

In: Ophthalmologica, Vol. 219, No. 6, 01.11.2005, p. 366-372.

Research output: Contribution to journalArticle

Yang, Chang Sue ; Tsai, Der Chong ; Lee, Fenq Lih ; Hsu, Wen-Ming. / Retinal arterial macroaneurysms : Risk factors of poor visual outcome. In: Ophthalmologica. 2005 ; Vol. 219, No. 6. pp. 366-372.
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AB - Purpose: To evaluate the long-term natural course and to identify the risk factors of a poor visual outcome in patients with retinal arterial macroaneurysms (MA). Methods: In this observational case series, we retrospectively evaluated the consecutive patients with MA at our institution over a 17-year period. The visual outcomes of the different types of MA (presented as predominantly hemorrhagic or exudative) were compared. Results: A total of 31 patients with 46 confirmed MA were identified. The ocular manifestations of MA included retinal hemorrhage (96.7%), retinal exudate (61.3%), macular involvement (77.4%) and vitreous hemorrhage (12.9%). Among the 10 cases of hemorrhagic-type MA, visual acuity improved by 2 or more lines in 9 (90%) and decreased in 1 patient (10%). In the 15 cases of exudative-type MA, 4 improved (26.7%), 8 remained stationary (53.3%) and 3 had decreased visual acuity (20.0%). The average vision change in the minimum angle of resolution improved by 0.59 log units in hemorrhagic MA and decreased by 0.07 log units in exudative MA (p < 0.01). With respect to change of vision, the eyes with hemorrhagic-type MA showed greater improvement than those with the exudative type, but the final visual outcome was not different in the 2 groups. Foveal exudate was a statistically significant risk factor for final vision equal to or worse than 6/30 (odds ratio = 6.93, p < 0.05). Conclusions: Different types of MA may have different clinical presentations. In the majority of MA, there is gradual and spontaneous involution. However, poor visual outcome may occur secondary to foveal exudates and subfoveal hemorrhage.

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