Three-dimensional locations of ruptured retinal arterial macroaneurysms and their associations with the visual prognosis

Saori Sakaguchi,Akihito Uji,Akitaka Tsujikawa,Masaharu Ishikura,Tomoaki Murakami,Naomi Nishigori,Manabu Miyata,Sotaro Ooto,Masahiro Miyake,Yuki Muraoka,Shin Kadomoto

doi:10.1038/s41598-021-04500-4

Abstract

The aim of this retrospective, observational study was to examine the intraretinal locations of ruptured retinal arterial macroaneurysms (RMAs) and investigate the associations with the visual prognosis. Fifty patients (50 eyes) with untreated RMA rupture who visited the Department of Ophthalmology at Kyoto University Hospital (April 2014–July 2019) were included. The intraretinal position of the ruptured RMAs relative to the affected retinal artery was examined using optical coherence tomography (OCT) and color fundus photography (CFP). The relative RMA positions were anterior to (anterior type, 44%), at the same level as (lateral type, 20%), or posterior to (posterior type, 34%) the affected artery. At the initial visit, the posterior type showed greater subretinal hemorrhage thickness than did the lateral and anterior types (P = 0.016 and 0.006, respectively), and poorer visual acuity (VA) than did the anterior type (P = 0.005). At the final visit, the length of the foveal ellipsoid zone band defect was longer (P = 0.005) and VA was poorer (P < 0.001) for the posterior type than for the anterior type. The intraretinal positions of ruptured RMAs vary, affect the thickness of foveal subretinal hemorrhage and predict future damage to the foveal photoreceptors. The visual prognosis may be poor for posteriorly ruptured RMAs.

Highlights

The aim of this retrospective, observational study was to examine the intraretinal locations of ruptured retinal arterial macroaneurysms (RMAs) and investigate the associations with the visual prognosis
The purpose of this study was to evaluate the positions of ruptured RMAs relative to the affected retinal artery using optical coherence tomography (OCT) and ophthalmoscopic findings, and to investigate the association of the intraretinal location with the pattern of retinal hemorrhage and visual prognosis
We examined the associations between each hemorrhage pattern and the intraretinal location of RMAs; the detection rate for sub-internal limiting membrane (ILM) hemorrhage was not significantly associated with the depth of RMA, whereas that of subretinal hemorrhage was significantly lower in eyes with anteriorly ruptured RMAs (P = 0.033, chi-square test, Fig. 1)

Summary

Introduction

The aim of this retrospective, observational study was to examine the intraretinal locations of ruptured retinal arterial macroaneurysms (RMAs) and investigate the associations with the visual prognosis. The intraretinal position of the ruptured RMAs relative to the affected retinal artery was examined using optical coherence tomography (OCT) and color fundus photography (CFP). Retinal arterial macroaneurysm (RMA) is an acquired, focal dilation of a retinal artery, typically occurring within the first three bifurcations of the central retinal artery It is relatively common in elderly w omen[1,2,3,4]. The purpose of this study was to evaluate the positions of ruptured RMAs relative to the affected retinal artery using optical coherence tomography (OCT) and ophthalmoscopic findings, and to investigate the association of the intraretinal location with the pattern of retinal hemorrhage and visual prognosis

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Conclusion