Vitrectomy Combined with Internal Limiting Membrane Peeling for the Treatment of Hemorrhagic Retinal Arterial Macroaneurysm with "Multilayered" Hemorrhages.

Aims: To report clinical outcomes of pars plana vitrectomy combined with internal limiting membrane (ILM) peeling in the treatment of "multilayered" hemorrhages caused by hemorrhagic retinal arterial microaneurysm (RAM) in three cases.

Methods: Three patients with hemorrhagic RAM were reviewed. All patients underwent vitrectomy combined with ILM peeling. The diagnosis of RAM was confirmed by fluorescein angiography and optical coherence tomography after surgery.

Results: All patients had yellowish-white prominent lesions with preretinal, intraretinal, and subretinal hemorrhaging with or without macular edema. Several months after the vitrectomy, the multilayered hemorrhages resolved without recurrent hemorrhage in the macular area. The exudative retinal detachment and macular edema associated with the RAM resolved, and eventually the RAM resolved, leaving behind white fibrous tissue. The visual acuity was improved in all patients.

Conclusion: Vitrectomy combined with ILM peeling was an option for the treatment of RAM with "multilayered" hemorrhages. Postoperative visual acuity and anatomical structure were improved.