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To treat or not to treat: a clinical series of retinal arterial macroaneurysms: A single-center retrospective study.

ABSTRACT: Retinal arterial macroaneurysms (RAMs) develop as outpouchings of the arterial wall that is weakened by arteriosclerosis. The traditional treatment of RAMs comprises observation, focal laser photocoagulation, or surgery. Recently, intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs has been announced as an effective therapy for fovea-threatening RAMs and quickly improve visual acuity and central retinal thickness (CRT).In the retrospective series, medical charts and ocular images of 24 patients diagnosed as having RAM between May 2011 and November 2018 in our facility were reviewed to delineate clinical manifestations and visual prognosis in RAM patients receiving different treatment modalities. Twenty-four patients (25 eyes; 11 men and 13 women) were enrolled, and one eye with comorbidity of branch retinal vein occlusion was excluded. The mean age of the patients was 69.00?±?13.45 years. Fourteen patients (58.33%) had a history of hypertension, and 17 patients (70.83%) were aged >?60 years. Furthermore, patients with fovea-threatening RAMs presented with either hypertension or were aged >?60 years.Eyes with fovea involvement (n?=?18) were analyzed and separated into two groups according to their treatment modalities: those receiving anti-VEGF intravitreal injections (n?=?13) and observation only (n?=?5). The baseline visual acuity revealed no significant difference in the two groups. In patients receiving anti-VEGF intravitreal injections, a significantly better visual acuity was detected after anti-VEGF intravitreal injections than the baseline visual acuity (logMAR, 0.78?±?0.51 vs 1.52?±?0.48, P?

SUBMITTER: Cho WH

PROVIDER: S-EPMC7004597 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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To treat or not to treat: a clinical series of retinal arterial macroaneurysms: A single-center retrospective study.

Cho Wan-Hua WH Chiang Wei-Yu WY Chen Chih-Hsin CH Kuo Hsi-Kung HK

Medicine 20200101 5

Retinal arterial macroaneurysms (RAMs) develop as outpouchings of the arterial wall that is weakened by arteriosclerosis. The traditional treatment of RAMs comprises observation, focal laser photocoagulation, or surgery. Recently, intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs has been announced as an effective therapy for fovea-threatening RAMs and quickly improve visual acuity and central retinal thickness (CRT).In the retrospective series, medical charts and oc ...[more]

PMID: 32000459

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Project description:PurposeTo observe the clinical and imaging characteristics of radiation-induced optic neuropathy (RION).MethodsWe retrospectively reviewed the clinical data of 43 patients (69 eyes) who were diagnosed with RION at the Chinese PLA General Hospital from 2010 to 2021.ResultsThe latency from radiotherapy to onset of visual loss ranged from 1 to 132 (36.33 ± 30.48) months. Optic disc pallor and optic disc edema were found in 27.0% (10/37) and 8.1% (3/37) of the eyes, respectively, within 2 months. After treatment, the best corrected visual acuity (BCVA) was restored in 24.6% (17/69) of the eyes and the final BCVA improved in 13.0% (9/69) of the eyes. An 82.5% (33/40) of the eyes with magnetic resonance imaging (MRI) showed enhancement of the affected optic nerve, mostly (69.7%) in the intracranial segment, and 36.4% (12/33) of the eyes with expansion and T2-high signals also showed enhancement of the affected optic nerve. The superior retinal nerve fiber layer (RNFL) and the outer circle superior quadrant (OS) of the inner limiting membrane to retinal pigment epithelium (ILM-RPE) layer thinned significantly during the first month. The center of the ILM-RPE layer thickened significantly during the first two months and the inner circle temporal quadrant (IT) of the ILM-RPE layer thickened significantly from the third to sixth month. The RNFL thinned significantly after 6 months except for the temporal quadrant, and the average inner circle superior quadrant (IS) and outer circle of the ILM-RPE layer thinned significantly after 6 months. There was no significant difference between hyperbaric oxygen therapy (HBOT) and high-dose intravenous methylprednisolone (IVMP) therapy in improving BCVA recovery or final BCVA (P > 0.05).ConclusionsThe structural damage of the RNFL and ILM-RPE layer occurred during the first month, the RNFL showed progressive thinning during the follow-up period, while the ILM-RPE layer showed thinning during the first month, thickening from the third to sixth month, and thinning after 6 months. There was a discrete region of enhancement of the optic nerve, often with expansion and high-T2 signals on MRI. HBOT and high-dose IVMP therapy were hardly effective for treating RION in the non-acute stage.

Dataset Information

To treat or not to treat: a clinical series of retinal arterial macroaneurysms: A single-center retrospective study.

Publications

To treat or not to treat: a clinical series of retinal arterial macroaneurysms: A single-center retrospective study.

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