Large Retinal Capillary Aneurysm: Clinical Features, Multimodal Imaging Characteristics, and Treatment Outcomes of Primary and Secondary Lesions

Retina. 2026 Feb 1;46(2):351-360. doi: 10.1097/IAE.0000000000004665.

Summary

Large retinal capillary aneurysms: Clinical features, multimodal imaging, treatment outcomes of primary and secondary lesions. Retrospective, 34 eyes.

Abstract

Purpose: To compare the clinical features, multimodal imaging characteristics, and treatment outcomes of primary and secondary large retinal capillary aneurysms (LRCAs).

Methods: A total of 34 eyes were included: seven with primary LRCA and 27 with secondary LRCA. All patients underwent fundus photography, optical coherence tomography (OCT), and fundus fluorescein angiography. Indocyanine green angiography and OCT-angiography were performed in selected cases. Various clinical, morphologic, and vascular features and treatment outcomes were evaluated and compared between the primary and secondary LRCA groups.

Results: All lesions in the primary LRCA group were unilateral, and five of seven were unifocal. However, in the secondary LRCA group, 19% of patients had bilateral involvement and lesions were multifocal in 48% of eyes. OCT characteristics, including the horizontal and vertical diameters of aneurysmal lesions and mean subfoveal choroidal thickness, were similar for the groups ( P > 0.05). During follow-up, neither visual acuity nor central macular thickness changed significantly in the primary LRCA group and no cases responded to treatment, whereas these improved significantly in the secondary LRCA group.

Conclusion: Clinical and imaging characteristics of primary and secondary LRCA lesions were similar, although treatment outcomes were more favorable in secondary LRCA lesions because of the differing pathophysiology and etiology.