Retinal arterial macroaneurysm rupture caused by dissection-like change in the vessel wall

Masaharu Ishikura; Yuki Muraoka; Shin Kadomoto; Naomi Nishigori; Tomoaki Murakami; Sotaro Ooto; Akitaka Tsujikawa

doi:10.1016/j.ajoc.2022.101346

Retinal arterial macroaneurysm rupture caused by dissection-like change in the vessel wall

Am J Ophthalmol Case Rep. 2022 Jan 26:25:101346. doi: 10.1016/j.ajoc.2022.101346. eCollection 2022 Mar.

Authors

Masaharu Ishikura¹, Yuki Muraoka¹, Shin Kadomoto¹, Naomi Nishigori¹, Tomoaki Murakami¹, Sotaro Ooto¹, Akitaka Tsujikawa¹

Affiliation

¹ Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shougoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

Abstract

Purpose: To highlight a potential pathogenetic mechanism of retinal arterial macroaneurysm.

Observations: A 79-year-old woman presented with a ruptured retinal arterial macroaneurysm in the right eye. One year after treatment, high-resolution multimodal imaging with optical coherence tomography (OCT), OCT angiography, and adaptive optics scanning light ophthalmoscope showed that a narrow passage developed in the vessel wall of the pre-existing retinal arterial macroaneurysm and another macroaneurysm had developed adjacent to the pre-existing one.

Conclusions and importance: These images suggest the pathogenesis of retinal arterial macroaneurysm (RAM) associated with crack-like changes in the retinal arterial wall, similar to pathologies seen in systemic arteries.

Keywords: Adaptive optics scanning light ophthalmoscope; Anti-vascular endothelial growth factor; Optical coherence tomography; Optical coherence tomography angiography; Retinal arterial macroaneurysm.

Publication types

Case Reports