Two suspected sequential retinal arterial macroaneurysms in a single eye with secondary nonvascular cystoid…

Abstract

Background: Retinal arterial macroaneurysm (RAM) is an acquired vascular disorder. The long-term natural history of multiple RAMs in a single eye complicated by nonvascular cystoid maculopathy (NVCM) is rarely documented.

Case presentation: A 65-year-old hypertensive woman presented with acute vision loss in her left eye secondary to severe vitreous hemorrhage. She underwent pars plana vitrectomy with intravitreal recombinant tissue plasminogen activator thrombolysis and silicone oil tamponade. Postoperative multimodal imaging supported the diagnosis of two suspected sequential RAMs confined to the left eye. Over a 5-year follow-up, the two lesions exhibited divergent outcomes: one developed fibrosis and persistent NVCM associated with severe initial hemorrhage and inadequate blood pressure control, whereas the other regressed completely following rigorous systemic hypertension management.

Conclusions: Multiple RAMs within the same eye can follow distinctly divergent natural courses. In this single case, early blood pressure control appeared to be an important contributing factor to the divergent lesion outcomes, although the contribution of spontaneous regression and other confounding factors cannot be excluded. Multimodal imaging is indispensable for differentiating NVCM from vasogenic macular edema, guiding individualized conservative management, and preventing unnecessary interventions.

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BibTeX RIS

BibTeX

@article{chi2026suspected,
  title = {{Two suspected sequential retinal arterial macroaneurysms in a single eye with secondary nonvascular cystoid macular edema: 5-year follow-up: a case report}},
  author = {Kaiyao Chi and Daoxi Lei and Tong Guo and Xiaoding Shui and Huili Li},
  journal = {Frontiers in medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fmed.2026.1953333},
  url = {https://europepmc.org/article/PMC/PMC13719403},
  note = {CC BY},
}

RIS

TY  - JOUR
TI  - Two suspected sequential retinal arterial macroaneurysms in a single eye with secondary nonvascular cystoid macular edema: 5-year follow-up: a case report
AU  - Kaiyao Chi
AU  - Daoxi Lei
AU  - Tong Guo
AU  - Xiaoding Shui
AU  - Huili Li
PY  - 2026
DA  - 2026/10/16
JO  - Frontiers in medicine
DO  - 10.3389/fmed.2026.1953333
UR  - https://europepmc.org/article/PMC/PMC13719403
AB  - Background: Retinal arterial macroaneurysm (RAM) is an acquired vascular disorder. The long-term natural history of multiple RAMs in a single eye complicated by nonvascular cystoid maculopathy (NVCM) is rarely documented.  Case presentation: A 65-year-old hypertensive woman presented with acute vision loss in her left eye secondary to severe vitreous hemorrhage. She underwent pars plana vitrectomy with intravitreal recombinant tissue plasminogen activator thrombolysis and silicone oil tamponade. Postoperative multimodal imaging supported the diagnosis of two suspected sequential RAMs confined to the left eye. Over a 5-year follow-up, the two lesions exhibited divergent outcomes: one developed fibrosis and persistent NVCM associated with severe initial hemorrhage and inadequate blood pressure control, whereas the other regressed completely following rigorous systemic hypertension management.  Conclusions: Multiple RAMs within the same eye can follow distinctly divergent natural courses. In this single case, early blood pressure control appeared to be an important contributing factor to the divergent lesion outcomes, although the contribution of spontaneous regression and other confounding factors cannot be excluded. Multimodal imaging is indispensable for differentiating NVCM from vasogenic macular edema, guiding individualized conservative management, and preventing unnecessary interventions.
SN  - 2296-858X
ER  -

Abstract

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