This 85 YO female with a retinal arterial macroaneurysm (RAM) continues to improve with 20/30 vision following a single Eylea injection four months earlier.
The macroaneurysm still appears patent. The old subretinal devitalized blood is devitalized and yellow. There are also multiple patches of resolving inferior subhyaloid blood.
Learning Points:
A RAM is thought to occur in a weakened arterial wall from arteriosclerosis and appears as a yellow-white dilated lesion along a retinal arteriole within the first 3 bifurcations from the optic nerve.
There are 2 distinct presentations: hemorrhagic or exudative. The hemorrhagic type often presents, as in this case, with pathognomonic preretinal, intraretinal, and subretinal blood. Acute macular hemorrhage can be treated with observation, anti-VEGF injections, or thermal laser.
