Papageorgiou Eleni, Vasiliki Dimera, Koufakis Dimitrios
Centre for Ophthalmology, University of Tübingen, Tübingen, Germany.
Eur J Ophthalmol. 2012 Sep-Oct;22(5):846-9. doi: 10.5301/ejo.5000126.
To present the unusual case of multiple retinal arterial macroaneurysms (RAMs) associated with an extensive submacular hemorrhage.
A 64-year-old hypertensive woman is presented including the clinical findings, fluorescein angiography, and optical coherence tomography.
The patient presented with 20/200 vision due to a dense submacular hemorrhage in the right eye. Fluorescein angiography revealed 4 hyperfluorescent lesions along the inferotemporal arteriole corresponding to RAMs. Optical coherence tomography confirmed RAM rupture with no choroidal abnormality. The patient refused surgical intervention. At 3-month follow-up, vision had improved to 20/70 with partial resolution of the hemorrhage. However, vitreoretinal traction with neurosensory retinal detachment involving the macula had developed.
Acquired RAMs are typically found as unilateral solitary lesions in older hypertensive women. The presence of 4 RAMs along the same arteriole has not been reported previously. Hypertensive patients should be examined regularly in order to detect potential RAMs early enough to permit treatment and prevent vision loss.
报告一例罕见的伴有广泛黄斑下出血的多发性视网膜动脉大动脉瘤（RAM）病例。
介绍一名64岁的高血压女性患者，包括临床检查结果、荧光素血管造影和光学相干断层扫描。
患者右眼因致密的黄斑下出血而视力为20/200。荧光素血管造影显示沿颞下小动脉有4个高荧光病变，对应于RAM。光学相干断层扫描证实RAM破裂，脉络膜无异常。患者拒绝手术干预。在3个月的随访中，视力提高到20/70，出血部分吸收。然而，已出现玻璃体视网膜牵拉伴累及黄斑的神经感觉性视网膜脱离。
获得性RAM通常在老年高血压女性中表现为单侧孤立性病变。此前尚未报道过沿同一小动脉出现4个RAM的情况。高血压患者应定期检查，以便尽早发现潜在的RAM，从而进行治疗并防止视力丧失。
