Juxtafoveal Retinal Arterial Macroaneurysm Diagnosed on Ancillary Imaging

Abstract

Purpose: To describe a case of retinal arterial macroaneurysm, a rare, focal arterial dilatation that is commonly found temporally within the first 3 orders of retinal arterial bifurcations. Methods: An observational case report was evaluated. Results: A 49-year-old man with prediabetes and hypercholesteremia presented with decreasing vision and a paracentral scotoma in the right eye. His ocular history was insignificant. There was significant intraretinal and subretinal fluid with perifoveal exudates. After 2 intravitreal injections of aflibercept for a tentative diagnosis of branch retinal vein occlusion, there was no improvement. Intravenous fluorescein angiography showed a small retinal arterial macroaneurysm less than 60 µm from the foveal avascular zone that was treated with low-power focal laser photocoagulation. This resulted in complete resolution of the macular edema with significant improvement in visual acuity. Conclusions: This rare and successfully treated case of an exudative juxtafoveal retinal arterial macroaneurysm highlights the importance of multimodal imaging in establishing an accurate diagnosis.