Surgical Excision of Retinal Macroaneurysms With Submacular Hemorrhage

Abstract

Abstract: : Purpose: To report the visual outcome following surgical excision of retinal macroaneurysms with submacular hemorrhage. Methods: Macroaneurysms were excised during vitrectomy using scissors and diathermy. Results: A 66–year–old woman presented with decreased vision associated with an extremely dense submacular hemorrhage and vitreous hemorrhage. Preoperative visual acuity was light perception. During the vitrectomy, a large retinal macroaneurysm of five to six disc diameters was found and surgically excised because it was too large to be treated by photocoagulation. A second vitrectomy was performed to treat the postoperative retinal detachment, and ten months later, the retina was attached and visual acuity was 20/2000. The second case was a 70–year–old woman who presented with decreased vision associated with submacular and preretinal hemorrhage. Preoperative visual acuity was 20/667. During the initial vitrectomy, the hemorrhages were removed and the macroaneurysm was photocoagulated. A second vitrectomy was performed because a vitreous hemorrhage occurred three weeks later. During the surgery, the recurrence of the submacular hemorrhage was found to be from the macroaneurysm and it was excised. Seven months after the excision, the visual acuity was maintained at 20/40, and no hemorrhage recurred. Conclusions: The surgical excision of retinal macroaneurysms is an effective procedure in cases with a macroaneurysm that is too large to be treated by photocoagulation and cannot be treated by direct photocoagulation during the vitrectomy.

Keywords: retina • vitreoretinal surgery