Introduction: Retinal arterial macroaneurysms are a rare cause of macular hemorrhage. Their treatment by photocoagulation is difficult and often ineffective.
Material and method: Five aneurysmal cases complicated by a pre or retromacular hematoma or an intravitreal hemorrhage were treated surgically by vitrectomy with peeling of the vitreous cortex, hematoma drainage, dissection of the fibrinous aneurysmal body, perfluorocarbon fluid tamponade facilitating endophotocoagulation and temporary internal gas tamponade.
Results: Anatomical and functional results were satisfactory in this short series. One year after surgery, one case of secondary cataract was reported.
Discussion: Arterial abnormalities, located on the superior temporal retinal artery, are often discovered after assessment pre or submacular hemorrhage. Functional prognosis of aneurysmal rupture depends on the course of the retrofoveal hematoma.
Conclusion: Early access to this surgery and good results in this series argue for rapid surgical treatment in sizeable submacular hemorrhage in order to avoid severe effects of subretinal fibrosis.