What is a retinal macroaneurysm?

A retinal macroaneurysm is an abnormal out-pouching in a retinal blood vessel (arteriole) where the arteriolar wall has been weakened. It looks like a tiny balloon in the blood vessel. The retina in your eye is like the film inside a camera. The retina “takes the picture” of objects you look at and sends the message to the brain. The retina is a living tissue, which requires blood supplied by tiny vessels. Retinal arterioles are blood vessels that bring blood to the retina.

Who is at risk for a retinal macroaneurysm?

Retinal macroaneurysms are more common in older people who have high blood pressure or hardening of the arteries. These conditions appear to weaken the blood vessels in the eye causing a ballooning of the vessel wall. Retinal macroaneurysms are NOT related to aneurysms in the brain.

What are the symptoms of a retinal macroaneurysm?

Blurring of vision may occur if excess fluid (edema) leaks from the macroaneurysm. Bleeding (vitreous hemorrhage) from a macroaneurysm causes floaters that can look like tiny dots or cobwebs moving about in your vision.  Sometimes, bleeding under the retina causes the sudden onset of a large blind spot in the vision.

What treatment is available?

Laser may improve the vision by sealing the macroaneurysm to keep it from bleeding and leaking fluid, but the vision rarely returns completely to normal. There may be some permanent damage to the retina from the macroaneurysm. In some cases the macroaneurysm may be observed without laser to see if it will heal on its own. In other cases, medication injections may be used to improve vision.  Your doctor is going to order appropriate tests and recommend the best course of action to take at this time. The retinal macroaneurysm will not be worsened by your daily activities or by using your eyes. See your internist to keep your blood pressure under good control.

By Scott E. Pautler, MD

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