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      Vitreous Hemorrhage Caused by Ruptured Retinal Macroaneurysm

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          Abstract

          Purpose: To report the clinical findings of 7 patients with a vitreous hemorrhage (VH) caused by a ruptured retinal macroaneurysm. Methods: Interventional case series. The medical records of 7 patients with a VH caused by a ruptured macroaneurysm and treated by either medication or vitrectomy were reviewed. The main outcome measures were the visual acuity, appearance of the fundus and optical coherence tomographic findings. Results: Two patients, aged 49 and 58 years, had retinal macroaneurysms at the optic disc. The retinal macroaneurysm in the other 5 eyes (mean age 79.0 years) was not at the optic disc. The VH was completely resolved in all 7 patients. The visual acuity improved in all eyes and remained stable for at least 6 months after the treatments (p = 0.0478). Conclusions: The improvement of the visual acuity in all eyes indicates that the prognosis of eyes with a VH caused by a ruptured retinal macroaneurysm is good.

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          Most cited references 16

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          Retinal arterial macroaneurysms.

           M Rabb,  D A Gagliano,  M Teske (2015)
          Retinal arterial macroaneurysms represent a distinct clinical entity. Macroaneurysms are seen in the elderly with a marked female predominance and a strong association with hypertension and arteriosclerotic vascular changes. The classic appearance provides an easy diagnosis; however, variable presentations, such as subretinal hemorrhage, macular exudate, and epiretinal membranes can make the diagnosis difficult. The differential diagnosis of retinal arterial macroaneurysms include retinal telangiectasia, angiomatosis retinae, venous macroaneurysms, background diabetic retinopathy, and cavernous hemangioma. The clinical characteristics of the reported cases are summarized, and our series of 60 patients is presented. The natural history of most macroaneurysms is spontaneous involution without loss of vision. However, visual loss may occur secondary to macular edema, exudate, hemorrhage and neurosensory retinal detachment, and photocoagulation may expedite visual recovery. Photocoagulation treatment may be applied directly to the macroaneurysm, indirectly by surrounding the macroaneurysm, or as a combination of these two methods.
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            Retinal artery macroaneurysms: clinical and fluorescein angiographic features in 34 patients.

            To describe the clinical and fluorescein angiographic features of patients with macroaneurysms (MAs) attending an ophthalmology department over 8 years. All the patients between 1997 and 2004 with a diagnosis of retinal artery MA were identified from hospital records. Photographs and fluorescein angiograms were examined, and the MAs classified according to their clinical (haemorrhagic or exudative) features, and angiographic (saccular or fusiform) features. Baseline data of the patients were taken including visual acuity and associated ocular and medical conditions. A total of 38 MAs were identified in 34 patients. The age at presentation ranged from 36 to 93 years, with a mean of 73.7 years. Of them, 24/34 (70%) were female patients, and 10/34 (30%) were male patients. There was a history of hypertension in 9/14 patients (64.3%). Of 38 MAs, 32 were identifiable as either saccular or fusiform. Of these, 22/32 (68.75%) were saccular, the rest fusiform. In all, 72.7% of the saccular MAs showed haemorrhage as the predominant feature. Of the 10 fusiform MAs, 90% showed haemorrhage as the predominant feature. Retinal artery macroaneurysm is a rare condition that may mimic a variety of other conditions. Most MAs do not require treatment. We suggest guidelines for diagnosis and propose a treatment algorithm for this condition.
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              Asymptomatic peripapillary subretinal hemorrhage: a study of 10 cases.

              Peripapillary subretinal hemorrhage (PSH) is often found together with optic disc drusen, optic disc edema, peripapillary subretinal neovascular membranes, vitreous traction, and bleeding diatheses. Previous reports have stated that such optic disc hemorrhages are associated with intrapapillary bleeding largely in patients of Asian origin who are visually symptomatic from this process. We have encountered patients with PSH who have clinical features that differ from those described in these reports.
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                Author and article information

                Journal
                COP
                COP
                10.1159/issn.1663-2699
                Case Reports in Ophthalmology
                S. Karger AG
                1663-2699
                2014
                January – April 2014
                01 February 2014
                : 5
                : 1
                : 44-49
                Affiliations
                Department of Ophthalmology, Takarazuka Daiichi Hospital, Hyogo, Japan
                Author notes
                *Kazunobu Asao, MD, Department of Ophthalmology, Takarazuka Daiichi Hospital, 19-5, Kogetsu-cho, Takarazuka-shi, Hyogo 665-0832 (Japan), E-Mail hirosaki1001@gmail.com
                Article
                358796 PMC3975200 Case Rep Ophthalmol 2014;5:44-49
                10.1159/000358796
                PMC3975200
                24707271
                © 2014 S. Karger AG, Basel

                Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) ( http://www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 2, Tables: 1, Pages: 6
                Categories
                Published: February 2014

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