Intraretinal Macroaneurysms and Multimodal Imaging: A Retrospective Analysis

Abstract

Purpose

To analyze the multimodal imaging characteristics of intraretinal macroaneurysms.

Patients and Methods

Intraretinal aneurysms larger than 150 μm in diameter on fluorescein angiography were termed as intraretinal macroaneurysm and grouped as primary and secondary according to the absence or presence of any coexisting posterior segment diseases.

Results

A total of 20 intraretinal macroaneurysms were observed in 18 eyes of 18 patients. Mean age of the cohort was 65.44 ± 9.14 years (Range; 49–82 years). Mean diameters of intraretinal macroaneurysms were 238.20 ± 61.12 μm (Range; 163.00–292.50 μm) and 242.72 ± 49.58 μm (Range; 168.00–328.00 μm) on fluorescein angiography and optical coherence tomography, respectively. Primary group had 10 eyes with 11 intraretinal macroaneurysms, whereas eight eyes had nine intraretinal macroaneurysms in the secondary group. Three of the eight eyes (37.5%) had diabetic retinopathy, four (50%), retinal vein occlusion, and one (12.5%), posterior uveitis in the secondary group. No statistically significant differences were found between the two groups in terms of age, sex, presence of intraretinal or subretinal fluid, the mean age, the mean central macular thickness, the mean distance of intraretinal macroaneurysms from the fovea, the mean diameter of intraretinal macroaneurysms measured on fluorescein angiography, and the mean diameter of intraretinal macroaneurysms measured on optical coherence tomography. Presence of intraretinal fluid was significantly more frequent than the presence of subretinal fluid in all eyes (p = 0.004).

Conclusion

Intraretinal macroaneurysms are diagnosed more and more with the utilization of multimodal imaging techniques. We propose a simple classification system in order to help achieving a standardized terminology and ensure consistent understanding. The classification can be simplified as primary or secondary intraretinal macroaneurysm according to the absence or presence of the associated posterior segment disorders.

Keywords:

• fluorescein angiography
• intraretinal macroaneurysm
• macular edema
• optical coherence tomography
• PEVAC
• retinal capillary macroaneurysm

Abbreviations

CMT, Central macular thickness; DR, Diabetic retinopathy; ePVAC, Exudative perifoveal vascular anomalous complex; FA, Fluorescein angiography; ICGA, Indocyanine green angiography; IMA, Intraretinal macroaneurysms; IRF, Intraretinal fluid; nePVAC, Non-exudative perifoveal vascular anomalous complex; OCT, Optical coherence tomography; OCTA, Optical coherence tomography angiography; PEVAC, Perifoveal exudative vascular anomalous complex; RPE, Retinal pigment epithelium; RVO, Retinal vein occlusion; SRF, Subretinal fluid; VEGF, Vascular endothelial growth factor.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Consent to Participate

This retrospective study was performed under the tenets of the Declaration of Helsinki on the patients examined at the Dokuz Eylul University Department of Ophthalmology between January 2019 and September 2022. The study was approved by the local ethics committee (Dokuz Eylul University, Approval ID: 2022/28-24).

Consent for Publication

The permission document which guarantees the use of personal information solely in an anonymous manner has been obtained from the local ethics committee together with the ethics approval.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no conflict of interest.

Additional information

Funding

There is no funding to report.