CASE DESCRIPTION
A 66-year-old female underwent an annual ophthalmologic examination by
her family doctor. At her last visit, fundus examination revealed a
retinal arterial microaneurysm (RAM) and mild retinal hemorrhage of the
right eye on ultra-wide-field pseudo-color fundus images (Figure A). She
had no visual symptoms; therefore, her family doctor ordered a follow-up
visit. Five days later, she returned due to the feeling of a strong
floater in her right eye. Vitreous hemorrhage associated with the RAM
was observed (Figure B). Vitrectomy was performed for removing the
vitreous hemorrhage, and a laser was applied to the RAM.
There are many treatments for RAM, but no standard treatment protocol
has been established. Most RAMs have a benign course of thrombosis,
fibrosis, and spontaneous resolution, and the vision returns to its
previous state.1 Therefore, RAM with no symptoms is
generally followed up. When edema or exudates due to RAM cause vision
loss, photocoagulation is usually considered.2Photocoagulation may be performed directly on macroaneurysms to
facilitate involution.
Preventive photocoagulation for the RAM in the annual ophthalmologic
examination might have prevented vitreous hemorrhage.