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Ruptured Retinal Arterial Macroaneurysm

Dedina, Liana MBBS (Hons I), MSc; Hassall, Mark M. MBBS, DPhil (Oxon); Anderson, Paula

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Asia-Pacific Journal of Ophthalmology: January-February 2021 - Volume 10 - Issue 1 - p 129
doi: 10.1097/APO.0000000000000356
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A 76-year-old female presented with a 2-week history of floaters in the left eye on a background of hypertension. Her vision was 6/6 in both eyes with a normal anterior segment. Posterior segment showed a well-demarcated pale retinal lesion, with corresponding auxiliary imaging confirming the diagnosis of a ruptured retinal arterial macroaneurysm (RAM) (Fig. 1). RAMs are acquired vascular abnormalities of the retinal arterioles. Main risk factors for RAMs are advancing age and hypertension.1 Although most RAMs do not require treatment, they can often mimic other more sinister conditions, such as choroidal melanoma.2

A, Colour fundus photograph showing a pale, well-demarcated area of subretinal blood and intraretinal haemorrhage overlying it, with B, corresponding autofluorescence. C, Fluorescein angiogram shows the focal area of leakage and surrounding blocked fluorescence. D, Hyperreflective areas on OCT are consistent with subretinal haemorrhage.


1. Lavin MJ, Marsh RJ, Peart S, et al. Retinal arterial macroaneurysms: a retrospective study of 40 patients. Br J Ophthalmol 1987; 71:817–825.
2. Shields CL, Shields JA. Subretinal hemorrhage from a retinal arterial macroaneurysm simulating a choroidal melanoma. Ophthalmic Surg Lasers 2001; 32:86–87.
Copyright © 2021 Asia-Pacific Academy of Ophthalmology. Published by Wolters Kluwer Health, Inc. on behalf of the Asia-Pacific Academy of Ophthalmology.